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Active NPI 1124655170 Individual Practitioner Male Practitioner

Abdul Ansari

Dermatology • Corona, CA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Abdul Ansari is a certified Dermatology practicing in Corona, CA. With approximately 6 years of clinical experience since completing medical education in 2020, Abdul Ansari delivers high-quality medical care to the local community at 21634 RETREAT PKWY.

Abdul Ansari is affiliated with Riverside Medical Clinic Inc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

21634 Retreat Pkwy

Corona, CA 928836100

Telephone 9517823818
Fax 9518268128
Associated Practice Facility / Clinic
🏢 Rmc Surgery Center Llc Facility NPI 1760043426

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Corona, CA

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -23.0 yrs vs City Avg
City Avg: 29.0 Yrs
State Avg: 24.9 Yrs
Regional Practice Density
6 Specialists

Practicing in Corona, CA (2182 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ansari (6 Years) 6 Yrs
Corona Specialty Average (29.0 Years) 29.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-09-15
Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License CA 20A24148

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Hospital & Practice Group Affiliations

Riverside Medical Clinic Inc

7160 Brockton Ave, Riverside, CA 925062614

Phone: 9517825110

Secondary Practice Locations

7160 Brockton Ave

Riverside, CA 925062620

Phone: 9517823837

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Mardy Lindt Fionne Diaz

Nurse Practitioner

NPI 1346707221
NPI 1881790418

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 15, 2025

Student in an Organized Health Care Education/Training Program

📍
Updated Practice Location September 02, 2025

Registered at 21634 RETREAT PKWY, CORONA, CA 928836100 (Tel: 9517823818)

📍
Updated Business Mailing Address September 02, 2025

Registered at 3660 ARLINGTON AVE, RIVERSIDE, CA 925063987

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2025

Dermatology (License #20A24148 in CA)

📍
Updated Practice Location June 16, 2022

Registered at 7031 SW 62ND AVE, SOUTH MIAMI, FL 331434701 (Tel: 3052847761)

📍
Updated Business Mailing Address June 16, 2022

Registered at 7031 SW 62ND AVE, SOUTH MIAMI, FL 331434701 (Tel: 3052847761)

NPI Profile Active March 26, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location March 26, 2020

Registered at 380 HOSPITAL DR STE 430, MACON, GA 312178017 (Tel: 4787510367)

📍
Updated Business Mailing Address March 26, 2020

Registered at 380 HOSPITAL DR STE 430, MACON, GA 312178017

👤
Provider Name / Credentials Updated March 26, 2020

Recorded as ABDUL ANSARI

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 26, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 26, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124655170
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 26, 2020
Last Update: September 15, 2025
Sole Proprietor: No

Mailing Address

3660 Arlington Ave

Riverside, CA 925063987

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.