Rod Mortazavi, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A123909 Issued in CA

Practice address

101 The City Dr S
Orange, CA 92868-3201

Phone

(714) 456-8888

NPI assigned

Mar 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of California, Irvine, California College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University ofGroup PAC ID 7517869605, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital - Orange County - Anaheim Hospital, Anaheim, CA, CCN 050609

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regents of the University of

  dba Emergency Medicine Faculty Group

  • Emergency Medicine Physician
  • Orange, CA
  • NPI 1154379394
  Medicare reassignment Care Compare group NPD
• Mission Viejo Emergency Medical Associates

  • Emergency Medicine Physician
  • Mission Viejo, CA
  • NPI 1073542916
  Medicare reassignment NPD
• Mission Viejo Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Laguna Beach, CA
  • NPI 1134355597
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Newport Emergency Medical Group Inc

  • Medical Specialty Clinic/Center
  • Newport Beach, CA
  • NPI 1922061779
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  dba Target Clinic Medical Associates of Southern California

  • Health Maintenance Organization
  • Fullerton, CA
  • NPI 1336556059
  NPD
• Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Oakland, CA
  • NPI 1508874454
  NPD (past)
• University of California Irvine

  dba UCI Infusion Center

  • Infusion Therapy Clinic/Center
  • Irvine, CA
  • NPI 1417027475
  NPD (past)

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital - Orange County - Anaheim Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1144375056
  Care Compare affiliation

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

{
    "created_epoch": "1300579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1891094678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Ashby Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052067",
            "country_code": "US",
            "telephone_number": "510-204-4723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORTAZAVI",
        "first_name": "ROD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-20",
        "last_updated": "2024-05-07",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A123909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashleigh Morrissey
• Linsey Jane Morro
• Andrew Raymond Morrow, DC
• Kenneth Wesley Morrow, MD
• Kasra Morshedizadeh, M.D.
• Michael Babak Mortazie, DO
• Fernanda Pagnillo Morton, LCSW
• Mithya Jayakumar Morton
• Sara Christine Morton, PA-C
• Mosaic Mental Health Group

• Emergency Medicine Physician in Orange, CA
• Providers in Orange, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.