Individual provider Active NPI

Khatere Naderi-Ashour, AGNP

  • Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1295446078
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95022144 Issued in CA
Practice address
113 Waterworks Way Ste 155
Irvine, CA 92618-3163
Phone
(949) 612-9090
Fax
(949) 612-9091
NPI assigned
Dec 12, 2022
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95022144 CA Primary

Addresses

Primary practice location

113 Waterworks Way Ste 155
Irvine, CA 92618-3163

Mailing address

113 Waterworks Way Ste 155
Irvine, CA 92618-3163
Phone (949) 612-9090

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215001010 CA Practitioner - Nurse Practitioner 0446694616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease Consultants of Orange County IncGroup PAC ID 7810057106, 14 clinicians

Practice addresses (Care Compare)

113 Waterworks Way
Suite 155
Irvine, CA 92618-3163
Phone (949) 612-9090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Consultants of Orange County Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

19582 Beach Blvd
Ste 270
Huntington Beach, CA 92648
Phone (714) 378-4920

113 Waterworks Way
Ste 155
Irvine, CA 92618
Phone (949) 764-5538

25982 Pala
Ste 140
Mission Viejo, CA 92691
Phone (949) 407-4404

15000 Kensington Park Dr
Ste 390
Tustin, CA 92782

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1295446078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 155",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183163",
            "telephone_number": "949-612-9090",
            "fax_number": "949-612-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 155",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183163",
            "telephone_number": "949-612-9090",
            "fax_number": "949-612-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADERI-ASHOUR",
        "first_name": "KHATERE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95022144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.