Ahmed Mohamed Mahdi, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95009179 Issued in CA

Practice address

12730 Heacock St Ste 4a
Moreno Valley, CA 92553-3040

Phone

(951) 243-8517

NPI assigned

Sep 11, 2018

Reactivated

Sep 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Remedial Patients Care Inc

  • Primary Care Clinic/Center
  • Corona, CA
  • NPI 1508507229
  Medicare reassignment NPD
• Remedial Medical Services Inc

  • General Practice Physician
  • Riverside, CA
  • NPI 1083216998
  NPD

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1467935858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 WILSHIRE BLVD APT 317",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102645",
            "telephone_number": "256-348-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12730 HEACOCK ST STE 4A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533040",
            "telephone_number": "951-243-8517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 S Central Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912044379",
            "country_code": "US",
            "telephone_number": "818-240-2233",
            "fax_number": "818-240-2237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHDI",
        "first_name": "AHMED",
        "middle_name": "MOHAMED",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2023-03-07",
        "deactivation_date": "2018-09-12",
        "reactivation_date": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95009179",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95009179",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "CA",
            "license": "95009179",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95009179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE NURSE PRACTITIONER",
            "identifier": "95009179",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alana DL Madril
• Anna Magee
• Magnicare LLC
• Mary Caroline Magpayo
• Sumana Mahata
• Sonya Maher, MD
• Lisa M Mahoney, MD
• Tri Xuan Mai, M.D.
• Mainstream Lifestyles, Inc.
• Michelle Drusilla Maisel

• Adult Health Nurse Practitioner in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.