Individual provider Active NPI

Sirus Farivar, MD

  • Gastroenterology Physician
  • Huntington Beach, CA
National Provider Identifier
1891896841
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A36333 Issued in CA
Practice address
17822 Beach Blvd
Ste 437
Huntington Beach, CA 92647-7101
Phone
(714) 841-7878
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A36333 CA Primary

Addresses

Primary practice location

17822 Beach Blvd
Ste 437
Huntington Beach, CA 92647-7101

Mailing address

17822 Beach Blvd
Ste 437
Huntington Beach, CA 92647-7101
Phone (714) 841-7878

Other identifiers 1

IdentifierTypeStateIssuer
00A363330MedicaidCA

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
I20100921001302 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 8123144615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical DoctorsGroup PAC ID 2961305651, 168 clinicians

Practice addresses (Care Compare)

400 Newport Ctr Dr
Suite 609
Newport Beach, CA 92660-7695
Phone (949) 760-0398

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36333CAMDClinical Psychologist
A36333CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Doctors CurrentSince Dec 15, 2015 Accepting new patients
United Medical Doctors Gastroenterology CurrentSince Dec 15, 2015 Accepting new patients
State of California - Department of Developmental Services CurrentSince Mar 16, 2016 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients

Locations

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

2501 Harbor Blvd
Costa Mesa, CA 92626
Phone (714) 957-5000

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

18111 Brookhurst St
Ste 5200
Fountain Vly, CA 92708
Phone (714) 962-7705

17822 Beach Blvd
Ste 437
Huntington Beach, CA 92647
Phone (714) 841-7878

19582 Beach Blvd
Ste 316
Huntington Beach, CA 92648
Phone (714) 378-2428

10861 Cherry St
Ste 107
Los Alamitos, CA 90720
Phone (562) 430-4449

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1891896841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD",
            "address_2": "STE 437",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477101",
            "telephone_number": "714-841-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD",
            "address_2": "STE 437",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477101",
            "telephone_number": "714-841-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIVAR",
        "first_name": "SIRUS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A36333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A363330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.