Individual provider Active NPI

Ahmad Naweed Kazem, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1003296096
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33300 Issued in CA
Practice address
4080 Centre St
Ste 202
San Diego, CA 92103-2657
Phone
(858) 342-7595
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33300 CA Primary

Addresses

Primary practice location

4080 Centre St
Ste 202
San Diego, CA 92103-2657

Mailing address

4080 Centre St
Suite 202
San Diego, CA 92103-2655
Phone (858) 342-7595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151019002419 CA Practitioner - Chiropractic 7719296466 Reassigns benefits to 1 organization
Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro de Salud de la Comunidad de San Ysidro,Inc.Group PAC ID 6901709435, 291 clinicians

Practice addresses (Care Compare)

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33300CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Dec 1, 2017 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Dec 1, 2017 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

704 E Grand Ave
Escondido, CA 92025

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1003296096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 CENTRE ST",
            "address_2": "SUITE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032655",
            "telephone_number": "858-342-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 CENTRE ST",
            "address_2": "STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032657",
            "telephone_number": "858-342-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZEM",
        "first_name": "AHMAD",
        "middle_name": "NAWEED",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.