MR. JAY BECKETT FEDERHART (NPI# 1568422558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568422558 |
| Entity Type | Individual |
| Full Name | MR. JAY BECKETT FEDERHART |
| Credential | MD |
| Practice Address |
28202 Cabot Rd Ste 300 Laguna Niguel CA 92677-1249 |
| Mailing Address |
488 E Valley Pkwy Suite 100 Escondido CA 92025-3363 |
| Practice Telephone | 9492638620 |
| Practice Fax Number | 8004097005 |
| Mailing Telephone | 7605208500 |
| Mailing Fax Number | 7605208520 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2015-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G84686 | CA | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
G84686 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1568422558 | 05 | |
| CA | BC/BS OF CA | G84686 | 01 |
| CA | 00G846860 | 05 |
| Street Address |
28202 CABOT RD STE 300 |
| City | LAGUNA NIGUEL |
| State | CA |
| Zip Code | 92677-1249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558820068 | Camelot Transportation LLC | Non-emergency Medical Transport (VAN) | 28202 Cabot Rd Ste 300, Laguna Niguel, CA 92677-1249 | 2019-03-14 |
| 1164845376 | Randall Jenks | Speech-Language Pathologist | 28202 Cabot Rd Ste 300, Laguna Niguel, CA 92677-1249 | 2014-01-23 |
| 1528264843 | Melissa Sarah Beck | Speech-Language Pathologist | 28202 Cabot Rd Ste 300, Laguna Niguel, CA 92677-1249 | 2007-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114566049 | Amber Kramer | Physical Therapist | 30100 Town Center Drive #yz, Laguna Niguel, CA 92677 | 2019-12-23 |
| 1811548340 | Morgan Peikar | Rehabilitation Hospital | 28441 Springfield Dr, Laguna Niguel, CA 92677 | 2019-09-25 |
| 1871056382 | Jacqueline Evamarie Serrano | Chiropractor | 28062 Forbes Road, Laguna Niguel, CA 92677 | 2019-04-11 |
| 1316408859 | Azadeh Ghafari | Social Worker | 30100 Town Center Dr # 179, Laguna Niguel, CA 92677 | 2019-03-27 |
| 1346741857 | Diana Wang | Physical Medicine & Rehabilitation | 30100 Town Center Drive Suite, Suite Yz, Laguna Niguel, CA 92677 | 2018-02-21 |
| 1750833554 | James H. Tran Dds, Dental Corp. | Dentist | 23876 Aliso Creek Road, Laguna Niguel, CA 92677 | 2016-10-27 |
| 1215486139 | Kevin Sun | Dentist | 49 Blue Horizon, Laguna Niguel, CA 92677 | 2016-10-04 |
| 1740637842 | Michael Dacosta | Dentist | 28862 Calle Vista, Laguna Niguel, CA 92677 | 2016-05-18 |
| 1235590373 | Adrian Gomez | Counselor | 24361 Nugget Falls Ln, Laguna Niguel, CA 92677 | 2016-03-17 |
| 1427455906 | Gracie Heart Home Health LLC | Home Health | 24318 El Pilar, Laguna Niguel, CA 92677 | 2014-11-26 |
| Find all providers in zip 92677 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1306467204 | Saleh Radiology of Inland Empire | Radiology | 15276 Ledgestone St, Fontana, CA 92336-4048 | 2020-05-01 |
| 1366084535 | Luo Xu | Radiology | 757 Westwood Plz # 2146, Los Angeles, CA 90095-8358 | 2019-10-09 |
| 1346717824 | Cvs Medical Group, Inc | Radiology | 201 W Garvey Ave Ste 102-502, Monterey Park, CA 91754-7418 | 2018-11-01 |
| 1407353675 | Art Vascular & Interventional Associates Inc | Radiology | 324 S Beverly Dr Ste 345, Beverly Hills, CA 90212-4801 | 2018-04-12 |
| 1568971869 | Broad Reach Specialty Surgery Inc | Radiology | 8117 West Manchester Ave, Ste 368, Playa Del Rey, CA 90293 | 2017-09-29 |
| 1407393754 | Valley Vascular Partners Inc | Radiology | 19231 Victory Blvd Ste 155, Reseda, CA 91335-6329 | 2017-01-25 |
| 1124497342 | Neurointerventional Surgery Consultants, PC | Radiology | 534 S Brea Blvd, Brea, CA 92821-5304 | 2015-09-17 |
| 1578946026 | Clarity Radiology, LLC | Radiology | 39 Via Navarro, Greenbrae, CA 94904-1215 | 2015-07-01 |
| 1669863981 | Pedes Vascular San Fernando Valley | Radiology | 16260 Ventura Boulevard, Suite 210, Encino, CA 91436-2203 | 2015-02-09 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA NIGUEL |
| Zip Code | 92677 |
Please comment or provide details below to improve the information on MR. JAY BECKETT FEDERHART.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.