Individual provider Active NPI

Adel Shawky Metry, M.D.

  • Cardiovascular Disease Physician
  • Gardena, CA
National Provider Identifier
1376638809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A44695 Issued in CA
Practice address
1141 W Redondo Beach Blvd Suite#406
Gardena, CA 90247
Phone
(310) 719-1653
Fax
(310) 719-1321
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A44695 CA Primary

Addresses

Primary practice location

1141 W Redondo Beach Blvd Suite#406
Gardena, CA 90247

Mailing address

1141 W Redondo Beach Blvd Suite#406
Gardena, CA 90247
Phone (310) 719-1653

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080508000416 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 0749369296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
May accept Medicare assignment
Group practices
Southern California Hospitalist Network Medical Group IncGroup PAC ID 8921990110, 76 clinicians

Practice addresses (Care Compare)

1141 W Redondo Beach Blvd
Suite 406
Gardena, CA 90247-3582
Phone (310) 719-1653

625 The City Dr S
Suite 320
Orange, CA 92868-4978
Phone (714) 202-2330

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A44695CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adel S. Metry,M.D. Inc. Cardiovascular Disease CurrentSince Oct 4, 2007 Accepting new patients
Southern California Hospitalist Network Medical Group Inc CurrentSince Jan 1, 2013 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Gardena Hospital LP Past Accepting new patients

Locations

1141 W Redondo Beach Blvd
Ste 406
Gardena, CA 90247
Phone (310) 515-1055

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376638809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD SUITE#406",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-719-1653",
            "fax_number": "310-719-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD SUITE#406",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-719-1653",
            "fax_number": "310-719-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METRY",
        "first_name": "ADEL",
        "middle_name": "SHAWKY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A44695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.