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AGEWELL MEDICAL GROUP INC
NPI 1649142399
Family Medicine in Burbank, CA

Active since September 22, 2025
142 W VERDUGO AVE, BURBANK, CA 91502(818) 588-3705(818) 588-3685 Get Directions Write a Review

NPPES record last updated: November 7, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Agewell Medical Group Inc NPPES

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

AGEWELL MEDICAL GROUP INC (NPI 1649142399) is a healthcare organization registered as a family medicine in Burbank, California and active in the NPI registry since September 2025. The organization lists Basem Farag, President/md, as its authorized official.

NPPES Registry Identity

NPI1649142399
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameAGEWELL MEDICAL GROUP INC
Location Address142 W VERDUGO AVEBurbank, CA 91502-2132
Mailing Address142 W Verdugo AveBurbank, CA 91502-2132 · (818) 588-3705 · Fax (818) 588-3685
Phone(818) 588-3705
Fax(818) 588-3685
Organization SubpartNo
Authorized OfficialBasem FaragPresident/md · (818) 588-3705
Enumeration DateSeptember 22, 2025
Last NPPES UpdateNovember 7, 2025
NPPES CertifiedNovember 7, 2025
✔ NPI 1649142399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
142 W VERDUGO AVE, Burbank, CA 91502
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Agewell Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Agewell Medical Group Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Basem Farag, M.D
Family Practice
NPI 1457441974
3300 E SOUTH ST STE 201
Lakewood, CA 90805
(626) 524-4132
✔ PECOS✔ Accepts Medicare24 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Agewell Medical Group Inc's NPI number?

The NPI number for Agewell Medical Group Inc is 1649142399. It was assigned to this organization in the NPPES registry on September 22, 2025.

Where is Agewell Medical Group Inc located?

Agewell Medical Group Inc is located at 142 W Verdugo Ave, Burbank, CA 91502. The listed phone number is (818) 588-3705.

What is Agewell Medical Group Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Agewell Medical Group Inc enrolled in Medicare?

Yes. Agewell Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Agewell Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Agewell Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Agewell Medical Group Inc was last updated on November 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.