Individual provider Active NPI

Kekoa Christian Ede, MD

  • Psychiatry Physician
  • Escondido, CA
National Provider Identifier
1134224843
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A101211 Issued in CA
Practice address
488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374
Phone
(760) 520-8100
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A101211 CA Primary
Internal Medicine Physician 207R00000X MD-12408 HI
Internal Medicine Physician 207R00000X A101211 CA
Psychiatry Physician 2084P0800X MD-12408 HI

Addresses

Primary practice location

488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374

Mailing address

488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374
Phone (760) 520-8100

Other practice location 1

460 N Elm St
Escondido, CA 92025-3002
Phone (760) 520-8100

Other identifiers 2

IdentifierTypeStateIssuer
W14158OtherCASITE MEDICARE NUMBER
ZZZ20041ZOtherCASITE MEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071203000713 CA Practitioner - Internal MedicinePractitioner - Psychiatry 0840389524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

460 N Elm St
Escondido, CA 92025-3002
Phone (760) 520-8100

855 E Madison Ave
El Cajon, CA 92020-3819
Phone (619) 440-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
101211CAMDMarriage & Family Therapist
A101211CAMDInternal Medicine Physician
MD-12408HIMDPsychiatry Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kekoa.ede@nh.eclinicaldirectplus.com

Organizations & group practices 1

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1134224843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 E VALLEY PKWY STE 311",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253374",
            "telephone_number": "760-520-8100",
            "fax_number": "760-737-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 E VALLEY PKWY STE 311",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253374",
            "telephone_number": "760-520-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920253002",
            "country_code": "US",
            "telephone_number": "760-520-8100",
            "fax_number": "760-737-2039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDE",
        "first_name": "KEKOA",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A101211",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-12408",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A101211",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-12408",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE MEDICARE NUMBER",
            "identifier": "W14158",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE MEDICARE NUMBER",
            "identifier": "ZZZ20041Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.