Roshan Razavi, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

B5147164 Issued in CA

Practice address

1117 Devonshire Ave
Attn: Carol Wood, Gme Office, Hemet Valley Medical Cent
Hemet, CA 92543

Phone

(760) 975-1239

NPI assigned

May 4, 2016

Last updated

Sep 6, 2017By the provider in NPPES

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

Other names 1

• Roashan Razavi Other name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1891140265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR.",
            "address_2": "DEPT OF FAMILY MEDICINE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "760-975-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 DEVONSHIRE AVE",
            "address_2": "ATTN: CAROL WOOD, GME OFFICE, HEMET VALLEY MEDICAL CENT",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "760-975-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZAVI",
        "first_name": "ROSHAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-11066",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "B5147164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROASHAN",
            "last_name": "RAZAVI",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anisha Rastogi, M.D.
• Celeste J Ratajczak, FNP-BC
• Ratan L Tiwari, M.D., Inc.
• Jahnavi Rao Ravulapalli, MD
• Keyla Mirella Raya, MA
• Reach the Valley
• Surya M Reddy, MD
• Derek Redmon
• Redwood Counseling a Licensed Clinical Social Worker Professional Corp
• Savonna Samone Reed, DPT

• General Practice Physician in Hemet, CA
• Providers in Hemet, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.