Individual provider Active NPI

Cyrus Damirchi, M.D.

  • Family Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1891883401
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A50298 Issued in CA
Practice address
355 E 21St St Ste F
San Bernardino, CA 92404-4851
Phone
(909) 886-5251
Fax
(949) 631-1798
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A50298 CA Primary

Addresses

Primary practice location

355 E 21St St Ste F
San Bernardino, CA 92404-4851

Mailing address

355 E 21St St Ste F
San Bernardino, CA 92404-4851
Phone (909) 886-5251

Other identifiers 1

IdentifierTypeStateIssuer
00A502980MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090515000434 CA Practitioner - Family Practice 4587713896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

355 E 21St St
Suite F
San Bernardino, CA 92404-4851
Phone (909) 886-5251

901 Dover Dr
Suite 231
Newport Beach, CA 92660-5515
Phone (949) 631-5252

Hospital & facility affiliations

  • St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50298CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of San Bernardino Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Dignity Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 1

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1891883401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E 21ST ST STE F",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044851",
            "telephone_number": "909-886-5251",
            "fax_number": "949-631-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E 21ST ST STE F",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044851",
            "telephone_number": "909-886-5251",
            "fax_number": "949-631-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIRCHI",
        "first_name": "CYRUS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A50298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A502980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.