Individual provider Active NPI

Amad Edward Kadry, M.D.

  • Family Medicine Physician
  • Vista, CA
National Provider Identifier
1396855235
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A32917 Issued in CA
Practice address
145 Thunder Dr
Vista, CA 92083-6010
Phone
(760) 941-9002
Fax
(760) 630-2515
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A32917 CA Primary

Addresses

Primary practice location

145 Thunder Dr
Vista, CA 92083-6010

Mailing address

11 Technology Dr
Irvine, CA 92618-2302
Phone (949) 923-3277

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
I20081031000415 CA Practitioner - Family Practice 7315908985 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cassidy Medical Group Inc. Current Accepting new patients
Beaver Medical Group P C Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Beaver Medical Group P C CurrentSince Mar 1, 2023 Accepting new patients
Amad E Kadry, M.D. Family Medicine PastSince Jan 1, 1990 Accepting new patients
Coast Medical Center, Inc. Family Medicine Past Accepting new patients

Locations

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1396855235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TECHNOLOGY DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182302",
            "telephone_number": "949-923-3277",
            "fax_number": "855-812-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 THUNDER DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836010",
            "telephone_number": "760-941-9002",
            "fax_number": "760-630-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADRY",
        "first_name": "AMAD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A32917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.