Individual provider Active NPI

Adnan Akhtar, D.O.

  • Internal Medicine Physician
  • Costa Mesa, CA
National Provider Identifier
1215126396
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A9286 Issued in CA
Practice address
301 Victoria St
Costa Mesa, CA 92627-1995
Phone
(949) 642-2734
NPI assigned
Oct 15, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A9286 CA Primary

Addresses

Primary practice location

301 Victoria St
Costa Mesa, CA 92627-1995

Mailing address

1590 Adams Ave
Unit 2882
Costa Mesa, CA 92628-4873
Phone (323) 728-0411

Other identifiers 2

IdentifierTypeStateIssuer
1427462175MedicaidCA
619512-02MedicaidHI

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
I20080208000521 CA Practitioner - Internal Medicine 2264515543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 Victoria St
Costa Mesa, CA 92627-1995
Phone (949) 642-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9286CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adnan Akhtar D.O. Inc Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

1590 Adams Ave
Unit 2882
Costa Mesa, CA 92628

301 Victoria St
Costa Mesa, CA 92627
Phone (949) 207-3457

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215126396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 ADAMS AVE",
            "address_2": "UNIT 2882",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926284873",
            "telephone_number": "323-728-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 VICTORIA ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271995",
            "telephone_number": "949-642-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKHTAR",
        "first_name": "ADNAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A9286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427462175",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "619512-02",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.