Coastal Vascular Medicine Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COASTAL VASCULAR MEDICINE INC

Practice address

320 Superior Ave Ste 250
Newport Beach, CA 92663-2778

Phone

(949) 631-6002

Fax

(949) 631-6982

NPI assigned

Jul 23, 2014

Organization subpart

No

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

Authorized official

Name

Ehab Nabil Hanna MadyNPI 1265600795

Title

Owner

Phone

(949) 631-6002

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GJGDCD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ehab Nabil Hanna Mady, D.O.

  • Specialist
  • Newport Beach, CA
  • NPI 1265600795
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1104234194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SUPERIOR AVE STE 250",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632778",
            "telephone_number": "949-631-6002",
            "fax_number": "949-631-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SUPERIOR AVE STE 250",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632778",
            "telephone_number": "949-631-6002",
            "fax_number": "949-631-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL VASCULAR MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "MADY",
        "authorized_official_first_name": "EHAB",
        "authorized_official_middle_name": "NABIL HANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-631-6002"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "10166",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Kids, a Professional Medical Corporation (Coastal Kids)
• Coastal Minds Counseling Center
• Coastal Psychological Services, Inc.
• Coastal Recovery Health and Wellness, Inc.
• Coastal Spine and Orthopedics Specialist, Inc
• Coastline Pediatric Cardiology, P.C. (Coastline Pediatric Cardiology)
• Jason Coble, P.T.
• Ashley Coccaro, LMFT
• Rachel Pons Codde, AMFT
• Shelly Rose Coe, M.D.

• Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.