NPIMap

Organization Active NPI

Pathway Medical Group, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Santa Ana, CA
National Provider Identifier
1295026078
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PATHWAY MEDICAL GROUP, INC.
Practice address
2621 S Bristol St
#203
Santa Ana, CA 92704-5766
Phone
(714) 662-2256
Fax
(714) 662-0178
NPI assigned
Apr 27, 2011
Organization subpart
Yes
Parent organization
PATHWAY MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Authorized official

Name
Dr. Hassan M Alkhouli, M.D.
Title
C.E.O.
Phone
(714) 379-2411

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

2621 S Bristol St
#203
Santa Ana, CA 92704-5766

Mailing address

PO Box 2989
Seal Beach, CA 90740-1989
Phone (714) 379-3221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041026000511 CA Part B Supplier - Clinic/Group Practice 5092776690 Receives reassigned benefits from 28 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, CA; Garden Grove, CA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Pathway Medical Group Inc

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1295026078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2989",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907401989",
            "telephone_number": "714-379-3221",
            "fax_number": "714-379-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 S BRISTOL ST",
            "address_2": "#203",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045766",
            "telephone_number": "714-662-2256",
            "fax_number": "714-662-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHWAY MEDICAL GROUP, INC.",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "ALKHOULI",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "714-379-2411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.