NPIMap

Individual provider Active NPI

Soorena Fatehchehr, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Long Beach, CA
National Provider Identifier
1891081253
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
A132575 Issued in CA
Practice address
529 E 10TH St FL 2
Long Beach, CA 90813-4508
Phone
(562) 491-9047
Fax
(562) 491-9251
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X A132575 CA Primary

Addresses

Primary practice location

529 E 10TH St FL 2
Long Beach, CA 90813-4508

Mailing address

4250 Glencoe Ave Unit 1114
Marina del Rey, CA 90292-5660
Phone (562) 491-9047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190205000894 CA Practitioner - Obstetrics/GynecologyPractitioner - Urology 6305136789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kern County Hospital AuthorityGroup PAC ID 4688964521, 264 clinicians

Practice addresses (Care Compare)

529 E 10TH St
FL 2
Long Beach, CA 90813-4508
Phone (562) 491-9047

9330 Stockdale Hwy
Suite 400
Bakersfield, CA 93311-3615
Phone (661) 664-2200

Hospital & facility affiliations

  • St Mary Medical Center Hospital, Long Beach, CA, CCN 050191
  • Kern Medical Center Hospital, Bakersfield, CA, CCN 050315

Merit-based Incentive Payment System (MIPS)

Final score
87.97 of 100Reported as group
Quality
47.69
Promoting interoperability
100
Improvement activities
40
Cost
82.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10
Removal of the uterus12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A132575CAMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Soorena Fatehchehr MD Inc Urogynecology and Reconstructive Pelvic Surgery CurrentSince Jan 1, 2020 Accepting new patients
Kern County Hospital Authority CurrentSince Apr 2, 2020 Accepting new patients
Kern County Hospital Authority CurrentSince Apr 2, 2020 Accepting new patients
St. Mary Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

9330 Stockdale Hwy
Ste 400
Bakersfield, CA 93311
Phone (661) 654-0400

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

529 E 10th St
Fl 2
Long Beach, CA 90813
Phone (562) 491-9047

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1891081253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 GLENCOE AVE UNIT 1114",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925660",
            "telephone_number": "562-491-9047",
            "fax_number": "562-491-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 E 10TH ST FL 2",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134508",
            "telephone_number": "562-491-9047",
            "fax_number": "562-491-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEHCHEHR",
        "first_name": "SOORENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CA",
            "license": "A132575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.