ABDUL ANSARI
NPI 1124655170
Dermatology in Corona, CA

Active since March 26, 2020PECOS EnrolledAccepts Medicare Assignment
21634 RETREAT PKWY, CORONA, CA 92883(951) 782-3818(951) 826-8128 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 15, 2025, Sep 2, 2025, Mar 26, 2020 (3 updates tracked since 2020).

About Abdul Ansari NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ABDUL ANSARI (NPI 1124655170) is an individual dermatology provider in Corona, California, licensed in California (20A24148) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Riverside, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1124655170
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameABDUL ANSARI
Location Address21634 RETREAT PKWYCorona, CA 92883-6100
Mailing Address3660 Arlington AveRiverside, CA 92506-3987
Fax(951) 826-8128
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 26, 2020
Last NPPES UpdateSeptember 15, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2025
NPI 1124655170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in CA · 20A24148
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

21634 RETREAT PKWY, Corona, CA 92883

Secondary Practice Location 1

Location 17160 Brockton AveRiverside, CA 92506-2620 · Phone (951) 782-3837 · Fax (951) 328-9758

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Abdul Ansari is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749607984
PECOS Enrollment IDI20250920000001
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92883 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Surgery
21634 RETREAT PKWY
CORONA, CA 92883
Family Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Internal Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Family Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Family Medicine
21634 RETREAT PKWY
CORONA, CA 92883
Obstetrics & Gynecology
21634 RETREAT PKWY
CORONA, CA 92883
Internal Medicine
21634 RETREAT PKWY
CORONA, CA 92883

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Abdul Ansari's NPI number?

The NPI number for Abdul Ansari is 1124655170. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Abdul Ansari located?

Abdul Ansari practices at 21634 Retreat Pkwy, Corona, CA 92883. The listed phone number is (951) 782-3818.

What is Abdul Ansari's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Abdul Ansari enrolled in Medicare?

Yes. Abdul Ansari is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Abdul Ansari was last updated on September 15, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.