Reza Fardanesh

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A172279 Issued in CA

Practice address

757 Westwood PLZ
Los Angeles, CA 90095-3725

Phone

(310) 301-6800

Fax

(310) 794-9035

NPI assigned

Jun 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, NJ, CA3 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 3

Specialty

Diagnostic Radiology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beverly Radiology Medical Group IIIGroup PAC ID 3476466376, 327 clinicians

Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians

Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.13 of 100Reported as group

Quality

62.91

Promoting interoperability

100

Improvement activities

40

Cost

68.15

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 33)

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment Care Compare group NPD
• Desert Advanced Imaging Medical Center

  • Diagnostic Radiology Physician
  • Palm Desert, CA
  • NPI 1568416147
  Medicare reassignment Care Compare group NPD
• Martin Luther King Jr Community Medical Foundation

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1356899777
  Medicare reassignment NPD
• Columbiadoctors/Newyork-Presbyterianimaging

  • Specialist
  • New York, NY
  • NPI 1902345986
  Medicare reassignment NPD
• Memorial Nuclear Medicine Group

  • Nuclear Medicine Physician
  • New York, NY
  • NPI 1194702282
  Medicare reassignment NPD
• Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey

  • Medical Oncology Physician
  • Basking Ridge, NJ
  • NPI 1184637886

  Diagnostic Radiology

  Medicare reassignment NPD
• MSK Bergen

  • Medical Oncology Physician
  • Montvale, NJ
  • NPI 1558814657

  Diagnostic Radiology

  Medicare reassignment NPD
• MSK Monmouth

  • Medical Oncology Physician
  • Middletown, NJ
  • NPI 1922459163

  Diagnostic Radiology

  Medicare reassignment NPD
• Mskcc Radiology Group

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1639159692
  Medicare reassignment NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • San Bernardino, CA
  • NPI 1477872919
  NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Anaheim, CA
  • NPI 1972826774
  NPD

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1972763993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953725",
            "telephone_number": "310-301-6800",
            "fax_number": "310-794-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDANESH",
        "first_name": "REZA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "286765",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A172279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04698564",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamand Fararooy, PA-C
• Andrea Farase Trieu
• Faraz Medical Group, Inc
• Alexander Shibuya Farbstein, LCSW
• Rebeca Farca
• Sabrina Fardeheb
• Marjan Fardghassemi, PSYD.
• Hamidreza Fardghassemlou, PH.D., L.AC
• Fardin Dadvand
• Halina Fardin

• Diagnostic Radiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.