NPIMap

Individual provider Active NPI

Mohammad Adnan Elbatta

  • Gastroenterology Physician
  • Tustin, CA
National Provider Identifier
1316204894
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35133929 Issued in OH
Practice address
17400 Irvine Blvd Ste F
Tustin, CA 92780-3030
Phone
(714) 937-9400
Fax
(714) 937-9404
NPI assigned
Apr 20, 2012
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A162124 CA
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 35133929 OH Primary

Addresses

Primary practice location

17400 Irvine Blvd Ste F
Tustin, CA 92780-3030

Mailing address

17400 Irvine Blvd Ste F
Tustin, CA 92780-3030
Phone (714) 937-9400

Other practice location 1

790 E Bonita Ave Fl 2
Pomona, CA 91767-1906
Phone (909) 447-8585

Other practice location 2

3600 Kolbe Rd Ste 205
Lorain, OH 44053-1677
Phone (440) 960-4416

Other practice location 3

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Other identifiers 2

IdentifierTypeStateIssuer
0299053MedicaidOH
3025372MedicaidOH

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
I20190926003584 CA Practitioner - Gastroenterology 7618109422 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17400 Irvine Blvd
Suite F
Tustin, CA 92780-3030
Phone (714) 937-9400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy68
Upper gastrointestinal (GI) endoscopy for acid reflux101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A162124CAMDInternal Medicine Physician
35133929OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chaparral Medical Group, Inc. Internal Medicine Current Accepting new patients
Chaparral Medical Group, Inc. Internal Medicine CurrentSince Sep 30, 2019 Accepting new patients
Chaparral Medical Group Inc Internal Medicine CurrentSince Sep 30, 2019 Accepting new patients
Chaparral Medical Group, Inc. Current Accepting new patients
Chaparral Medical Group Inc. CurrentSince Sep 30, 2019 Accepting new patients
Mohammad Elbatta MD, Inc Gastroenterology CurrentSince Aug 24, 2022 Accepting new patients
Chaparral Medical Group Inc Internal Medicine Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
St Joseph Hospital of Orange Past 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

790 E Bonita Ave
Fl 2
Pomona, CA 91767
Phone (909) 447-8585

840 Towne Center Dr
Pomona, CA 91767

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

17400 Irvine Blvd
Ste F
Tustin, CA 92780
Phone (714) 838-5610

811 E 11th St
Ste 207
Upland, CA 91786
Phone (909) 629-5540

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDHAAA/Endpoint/FDHAAA
  • Direct secure messaging: melbatta802162@direct.memorialcare.org

Organizations & group practices 10

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 9

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": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1316204894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD STE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-937-9400",
            "fax_number": "714-937-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD STE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-937-9400",
            "fax_number": "714-937-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 E Bonita Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671906",
            "country_code": "US",
            "telephone_number": "909-447-8585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Kolbe Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Lorain",
            "state": "OH",
            "postal_code": "440531677",
            "country_code": "US",
            "telephone_number": "440-960-4416",
            "fax_number": "440-960-4417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELBATTA",
        "first_name": "MOHAMMAD",
        "middle_name": "ADNAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A162124",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35133929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0299053",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.