Syed Ahmed Athar, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

A108169 Issued in CA

Practice address

11201 Benton St
Loma Linda, CA 92357-1000

Phone

(909) 583-6097

Fax

(909) 777-3273

NPI assigned

Mar 31, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Ahmed Athar Other name

Medicare fee-for-service enrollment

Enrolled in IN, AR, OR3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Centennial Medical Group Inc.

  • Surgery Physician
  • Roseburg, OR
  • NPI 1518103274

  Cardiovascular Disease

  Medicare reassignment NPD
• St Mary's Physician Services LLC

  • General Practice Physician
  • Russellville, AR
  • NPI 1124084991
  Medicare reassignment NPD
• Porter Physician Services LLC

  • Family Medicine Physician
  • Valparaiso, IN
  • NPI 1508075680
  Medicare reassignment
• St Marys Physician Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Russellville, AR
  • NPI 1063626117
  NPD
• Centennial Medical Group Inc.

  dba Centennial Shaw Heart & Vascular Specialists

  • Cardiovascular Disease Physician
  • Roseburg, OR
  • NPI 1033365135
  NPD (past)
• St Marys Physician Services, LLC

  dba Cardiology Associates of North Central Arkansas

  • Interventional Cardiology Physician
  • Russellville, AR
  • NPI 1720356207
  NPD (past)

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1508038597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "909-583-6097",
            "fax_number": "909-777-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "909-583-6097",
            "fax_number": "909-777-3273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 NW Mercy Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974712348",
            "country_code": "US",
            "telephone_number": "541-677-1555",
            "fax_number": "541-677-2113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2205 W Main St",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "728012759",
            "country_code": "US",
            "telephone_number": "479-968-4311",
            "fax_number": "479-968-4399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATHAR",
        "first_name": "SYED",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A108169",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01065071A",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD192265",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AR",
            "license": "E-8144",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A108169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200244001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AHMED",
            "last_name": "ATHAR",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jerhet Russell Ask, DDS
• Mihran Nicholas Ask, MD
• Isabel Aste, DO
• Juan Andres Astudillo-Cordova, M.D.
• Kettlen Cristh Ataides Borda
• Corinne Atiga, DDS
• Philopatir Joseph Attalla, MD
• Abraam Attia
• Michelle L Ault, RN
• Rita Auro, MD

• Interventional Cardiology Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Interventional Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.