NPIMap

Individual provider Active NPI

Zavier Shawkat Ahmed, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
National Provider Identifier
1255677134
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A135146 Issued in CA
Practice address
11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505
Phone
(714) 241-9200
NPI assigned
Dec 20, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Nephrology Physician 207RN0300X A135146 CA Primary

Addresses

Primary practice location

11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505

Mailing address

11180 Warner Ave.
Ste 463
Fountain Valley, CA 92708-7505
Phone (714) 241-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180212002444 CA Practitioner - NephrologyPractitioner - Internal Medicine 1951661909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Renal Care Medical CorpGroup PAC ID 5092847384, 3 clinicians

Practice addresses (Care Compare)

11180 Warner Ave
Suite 463
Fountain Valley, CA 92708-7505
Phone (714) 241-9200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A135146CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince Nov 25, 2019 Accepting new patients
Pacific Renal Care Medical Corp Nephrology CurrentSince Jan 9, 2018 Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

11180 Warner Ave
Ste 463
Fountain Vly, CA 92708
Phone (714) 241-9200

11180 Warner Ave
Ste 465
Fountain Vly, CA 92708
Phone (714) 241-9200

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 7

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": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255677134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE.",
            "address_2": "STE 463",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087505",
            "telephone_number": "714-241-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 463",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087505",
            "telephone_number": "714-241-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "ZAVIER",
        "middle_name": "SHAWKAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A135146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.