Individual provider Active NPI

Hoda Haydari Ahwazi, MD

  • Family Medicine Physician
  • Lancaster, CA
National Provider Identifier
1952980336
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200826 Issued in CA
Practice address
43112 15TH St W
Lancaster, CA 93534-6269
Phone
(833) 574-2273
NPI assigned
Apr 5, 2021
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58543 KY
Family Medicine Physician 207Q00000X 200826 CA Primary

Addresses

Primary practice location

43112 15TH St W
Lancaster, CA 93534-6269

Mailing address

43112 15TH St W
Lancaster, CA 93534-6269
Phone (833) 574-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231211002128 KY Practitioner - General PracticePractitioner - Family Practice 7416333620 Reassigns benefits to 1 organization
I20250514003321 CA Practitioner - Family Practice 7416333620 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200826CAMDFamily Medicine Physician
58543KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Baptist Health Deaconess Medical Group Inc Family Medicine Current Accepting new patients
Bartz-Altadonna Community Health Center CurrentSince Apr 1, 2025 Accepting new patients
Bartz-Altadonna Community Health Center CurrentSince Apr 1, 2025 Accepting new patients

Locations

12560 Boron Ave
Boron, CA 93516
Phone (760) 762-5064

43210 Gingham Ave
Lancaster, CA 93535
Phone 6618744050222

43322 Gingham Ave
Lancaster, CA 93535
Phone (661) 579-9317

43322 Gingham Ave
Ste 105
Lancaster, CA 93535
Phone 6618744050222

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1851 N Main St
Madisonville, KY 42431
Phone (270) 821-7739

200 Clinic Dr
Madisonville, KY 42431
Phone (270) 821-8874

200 Clinic Dr
Fl 1
Madisonville, KY 42431
Phone (270) 825-6680

800 Hospital Dr
Fl 2
Madisonville, KY 42431
Phone (270) 326-3900

900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900

1010 Medical Center Dr
Powderly, KY 42367
Phone (270) 338-8000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1952980336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346269",
            "telephone_number": "833-574-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346269",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHWAZI",
        "first_name": "HODA HAYDARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "58543",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "200826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.