Individual provider Active NPI

Hawaa Elhaam Ali, O.D.

  • Optometrist
  • Newport Beach, CA
National Provider Identifier
1194955849
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13797 Issued in CA
Practice address
1000 Bristol St N Ste 29
Newport Beach, CA 92660-8917
Phone
(949) 476-2870
Fax
(949) 476-3087
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13797 CA Primary

Addresses

Primary practice location

1000 Bristol St N Ste 29
Newport Beach, CA 92660-8917

Mailing address

1000 Bristol St N Ste 29
Newport Beach, CA 92660-8917
Phone (949) 476-2870

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130619000327 CA Practitioner - Optometry 4385897560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Bristol St N
Suite 29
Newport Beach, CA 92660-8917
Phone (949) 476-2870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13797CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Optometry Group, Inc. Optometrist CurrentSince Aug 26, 2018 Accepting new patients
Aliso Optometry, Inc. Optometrist CurrentSince May 1, 2013 Accepting new patients
Pacific Optometric Group Optometrist Current Accepting new patients

Locations

27792 Aliso Creek Rd
Ste B124
Aliso Viejo, CA 92656
Phone (949) 362-3500

2 Journey
Ste 103
Aliso Viejo, CA 92656
Phone (949) 362-3500

1000 Bristol St N
Ste 29
Newport Beach, CA 92660
Phone (949) 476-2870

Organizations & group practices 3

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1194955849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BRISTOL ST N STE 29",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608917",
            "telephone_number": "949-476-2870",
            "fax_number": "949-476-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRISTOL ST N STE 29",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608917",
            "telephone_number": "949-476-2870",
            "fax_number": "949-476-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "HAWAA",
        "middle_name": "ELHAAM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.