Pathway Medical Group, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PATHWAY MEDICAL GROUP, INC

Practice address

12462 Brookhurst St
#A&B
Garden Grove, CA 92840-4759

Phone

(714) 636-9850

Fax

(714) 636-1248

NPI assigned

May 25, 2006

Last updated

May 6, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

PATHWAY MEDICAL GROUP, INCAs reported in NPPES

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

Authorized official

Name

Dr. Hassan M. Alkhouli, M.D.

Title

C.E.O.

Phone

(714) 379-3221

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pathway Medical Group, Inc

  • Internal Medicine Physician
  • Westminster, CA
  • NPI 1164473757

  O20041026000511

  Same enrollment
• Pathway Medical Group, Inc

  • Family Medicine Physician
  • Garden Grove, CA
  • NPI 1184670762

  O20041026000511

  Same enrollment
• Pathway Medical Group, Inc

  • Family Medicine Physician
  • Fountain Valley, CA
  • NPI 1578519054

  O20041026000511

  Same enrollment
• Pathway Medical Group, Inc

  • Family Medicine Physician
  • Garden Grove, CA
  • NPI 1902853302

  O20041026000511

  Same enrollment
• Pathway Medical Group, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Santa Ana, CA
  • NPI 1295026078

  O20041026000511

  Same enrollment
• Pathway Medical Group, Inc.

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1407199243

  O20041026000511

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Pathway Medical Group I

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mahmoud Youssef Abdallah, DO

  • Pulmonary Disease Physician
  • Garden Grove, CA
  • NPI 1871014027

  Internal Medicine

  NPD
• Negin Behazin, MD

  • Internal Medicine Physician
  • Garden Grove, CA
  • NPI 1497076301
  NPD
• Omar Othman Fadeel, M.D.

  • Internal Medicine Physician
  • Buena Park, CA
  • NPI 1922060086
  NPD
• Nazanin Parsaei, MD

  • Family Medicine Physician
  • Sherman Oaks, CA
  • NPI 1417104282

  Single Specialty

  NPD
• Theodore G Rose, MD

  • Internal Medicine Physician
  • Garden Grove, CA
  • NPI 1629088281
  NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1407802069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2989",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907401989",
            "telephone_number": "714-636-9850",
            "fax_number": "714-636-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12462 BROOKHURST ST",
            "address_2": "#A&B",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404759",
            "telephone_number": "714-636-9850",
            "fax_number": "714-636-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHWAY MEDICAL GROUP, INC",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "ALKHOULI",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "714-379-3221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100560",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100561",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samir Patel, MD
• Shekha Dashrath Patel, RPH
• Pathlab Services Inc
• Pathway Medical Group Inc (Pathway Medical Center- Garden Grove)
• Pathway Medical Group, Inc
• Pathway Medical Group, Inc
• Pathway Medical Group, Inc.
• Pathways Community Serivces LLC (CYS Clarvida - Garden Grove)
• Janet Patino-Cardova
• Phillip Dean Patocka II, RADT

• Family Medicine Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.