Individual provider Active NPI

Nader Javadi, M.D.

  • Specialist
  • Calabasas, CA
National Provider Identifier
1962405266
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H20156 Issued in CA
Practice address
24100 Calabasas Rd Ste 100
Calabasas, CA 91302-1636
Phone
(818) 578-6454
Fax
(818) 578-6571
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X H20156 CA Primary

Addresses

Primary practice location

24100 Calabasas Rd Ste 100
Calabasas, CA 91302-1636

Mailing address

24100 Calabasas Rd Ste 100
Calabasas, CA 91302-1636
Phone (818) 578-6454

Other identifiers 4

IdentifierTypeStateIssuer
1962405266MedicaidCA
W21577OtherCAMEDICARE GROUP
008677000MedicaidCA
A67700OtherCACA MEDICAL LICENSE

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
I20050119001014 CA Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Hematology 6800845546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24100 Calabasas Rd
Suite 100
Calabasas, CA 91302-1636
Phone (818) 578-6454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H20156CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Nader Javadi MD a Professional Corporation CurrentSince Jan 18, 2011 Accepting new patients
Nader Javadi MD a Professional Coporation Past Accepting new patients
BC Missouri Emergency Physicians, LLP Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients
Hope Health Center Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Nader Javadi MD a Professional Corporation Past Accepting new patients

Locations

303 S Glenoaks Blvd
Ste 6
Burbank, CA 91502
Phone (818) 842-8400

24100 Calabasas Rd
Ste 100
Calabasas, CA 91302
Phone (818) 578-6454

24100 Calabasas Rd
Calabasas, CA 91302
Phone (818) 578-6454

19231 Victory Blvd
Ste 103
Reseda, CA 91335
Phone (747) 265-6693

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1962405266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 CALABASAS RD STE 100",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021636",
            "telephone_number": "818-578-6454",
            "fax_number": "818-578-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 CALABASAS RD STE 100",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021636",
            "telephone_number": "818-578-6454",
            "fax_number": "818-578-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVADI",
        "first_name": "NADER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "H20156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962405266",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "W21577",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008677000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "A67700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.