Individual provider Active NPI

Sami Ahmed Ali, PA

  • Physician Assistant
  • Claremont, CA
National Provider Identifier
1306491121
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2248 N Mills Ave
Claremont, CA 91711-1950
Phone
(909) 261-6256
NPI assigned
Aug 8, 2019
Last updated
Aug 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

2248 N Mills Ave
Claremont, CA 91711-1950

Mailing address

2248 N Mills Ave
Claremont, CA 91711-1950
Phone (909) 261-6256

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
I20201119000612 CA Practitioner - Physician Assistant 3577974781 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57612CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Chaparral Medical Group Inc CurrentSince Apr 1, 2021 Accepting new patients
Chaparral Medical Group Inc. CurrentSince Apr 1, 2021 Accepting new patients

Locations

1801 W Olympic Blvd
Pasadena, CA 91199

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1306491121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 N MILLS AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111950",
            "telephone_number": "909-261-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2248 N MILLS AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111950",
            "telephone_number": "909-261-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "SAMI",
        "middle_name": "AHMED",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

Verify at the official NPI Registry.