Individual provider Active NPI

Ehab Nabil Hanna Mady, D.O.

  • Specialist
  • Newport Beach, CA
National Provider Identifier
1265600795
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
20A10166 Issued in CA
Practice address
320 Superior Ave Ste 250
Newport Beach, CA 92663-2778
Phone
(949) 631-6002
Fax
(949) 631-6982
NPI assigned
Feb 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A10166 CA
Specialist 174400000X 20A10166 CA Primary

Addresses

Primary practice location

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

Mailing address

320 Superior Ave Ste 250
Newport Beach, CA 92663-2778
Phone (949) 631-6002

Other identifiers 1

IdentifierTypeStateIssuer
P01398004OtherCAMEDICARE RAILROAD

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
I20090102000234 CA Practitioner - Internal MedicinePractitioner - Other (Physician) 6608938428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

320 Superior Ave
Suite 250
Newport Beach, CA 92663-2778
Phone (949) 631-6002

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
89.31 of 100Reported as individual
Quality
92.88
Promoting interoperability
97
Improvement activities
40
Cost
73.99

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal96

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Vascular Medicine Inc Specialist CurrentSince Aug 4, 2014 Accepting new patients

Locations

351 Hospital Rd
Ste 401
Newport Beach, CA 92663
Phone (949) 631-6002

320 Superior Ave
Ste 250
Newport Beach, CA 92663
Phone (949) 631-6002

510 Superior Ave
Ste 200B
Newport Beach, CA 92663
Phone (800) 400-4624

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ehab.mady.1@14021.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJGDCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJGDCD/Endpoint/GJGDCD

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.

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1265600795",
    "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": {
        "last_name": "MADY",
        "first_name": "EHAB",
        "middle_name": "NABIL HANNA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10166",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "20A10166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01398004",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.