NPIMap

Individual provider Active NPI

Javed Ahmad, MD

  • Internal Medicine Physician
  • Indio, CA
National Provider Identifier
1346354479
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A55292 Issued in CA
Practice address
81833 Doctor Carreon Blvd Ste 2
Indio, CA 92201-5590
Phone
(760) 863-0155
Fax
(760) 863-0199
NPI assigned
Aug 18, 2006
Last updated
Jun 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A55292 CA Primary

Addresses

Primary practice location

81833 Doctor Carreon Blvd Ste 2
Indio, CA 92201-5590

Mailing address

81833, Dr.Carreon Blvd.
Ste 2
Indio, CA 92201-5590
Phone (760) 863-0155

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
I20100210000173 CA Practitioner - Internal Medicine 5991848137 Reassigns benefits to 1 organization
Practice locations: Indio, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

81833 Dr Carreon Blvd
Suite 2
Indio, CA 92201-5590
Phone (760) 863-0155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55292CAMDDentist
A55292CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Javed Ahmad a Professional Medical Corporation Internal Medicine CurrentSince Apr 1, 2017 Accepting new patients
Eisenhower Medical Center Past Accepting new patients
Chandrashekar Medical Corporation Past Accepting new patients
JFK Memorial Hospital, Inc. Past Accepting new patients

Locations

81833 Doctor Carreon Blvd
Ste 2
Indio, CA 92201
Phone (760) 863-0155

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 6

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1346354479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81833, DR.CARREON BLVD.",
            "address_2": "STE 2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-863-0155",
            "fax_number": "760-863-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81833 DOCTOR CARREON BLVD STE 2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-863-0155",
            "fax_number": "760-863-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "JAVED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.