Individual provider Active NPI

Atul Madan, MD

  • Surgery Physician
  • Orange, CA
National Provider Identifier
1588620363
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C53803 Issued in CA
Practice address
1310 W Stewart Dr Ste 310
Orange, CA 92868-3838
Phone
(562) 270-5411
Fax
(424) 248-0985
NPI assigned
Apr 21, 2006
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C53803 CA Primary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X C53803 CA
Physician Nutrition Specialist (Surgery) 2086P0122X C53803 CA

Addresses

Primary practice location

1310 W Stewart Dr Ste 310
Orange, CA 92868-3838

Mailing address

10573 W Pico Blvd # 859
Los Angeles, CA 90064-2333
Phone (310) 869-7776

Other identifiers 1

IdentifierTypeStateIssuer
3876107MedicaidTN

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
I20120911000507 CA Practitioner - General Surgery 9133193287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Pennsylvania, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10540 W Olympic Blvd
Los Angeles, CA 90064-2316
Phone (213) 973-2263

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C53803CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atul K Madan MD a Medical Corporation Surgery CurrentSince Jun 26, 2012 Accepting new patients
Fatehchehr, Madan, Neoman Medical Practice, Inc. Surgery CurrentSince Jul 13, 2025 Accepting new patients

Locations

2250 S Main St
Ste 201
Corona, CA 92882
Phone (951) 621-3232

10573 W Pico Blvd
Los Angeles, CA 90064
Phone (310) 383-0920

Interoperability endpoints

  • Direct secure messaging: amadan392717@direct.memorialcare.org

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1588620363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10573 W PICO BLVD # 859",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642333",
            "telephone_number": "310-869-7776",
            "fax_number": "866-933-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 310",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683838",
            "telephone_number": "562-270-5411",
            "fax_number": "424-248-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADAN",
        "first_name": "ATUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C53803",
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "CA",
            "license": "C53803",
            "primary": false
        },
        {
            "code": "2086P0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Physician Nutrition Specialist",
            "state": "CA",
            "license": "C53803",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3876107",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.