Individual provider Active NPI

Ahmed Mayet Abdulrahim, D.C.

  • Chiropractor
  • Alpine, CA
National Provider Identifier
1619040292
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28335 Issued in CA
Practice address
1620 Alpine Blvd Ste 119
Alpine, CA 91901-1104
Phone
(619) 662-4100
NPI assigned
Nov 15, 2006
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 611492736 CA
Chiropractor 111N00000X DC28335 CA Primary

Addresses

Primary practice location

1620 Alpine Blvd Ste 119
Alpine, CA 91901-1104

Mailing address

1620 Alpine Blvd Ste 119
Alpine, CA 91901-1104
Phone (619) 662-4100

Other practice location 1

4094 4th Ave
San Diego, CA 92103-2143
Phone (619) 515-2545

Other identifiers 1

IdentifierTypeStateIssuer
1699216754MedicaidOK

Other names 1

  • Ahmed Mayet Abdulrahim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713002313 CA Practitioner - Chiropractic 3971905928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

525 E Main St
El Cajon, CA 92020-4007
Phone (619) 515-2498

7592 Broadway
Lemon Grove, CA 91945-1604
Phone (619) 515-2550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
611492736CAMDChiropractor
DC28335CAMDChiropractor
28335CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Oct 30, 2023 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Apr 26, 2021 Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Oct 30, 2023 Accepting new patients
Hillside Wellness Plllp Chiropractor PastSince Jul 24, 2022 Accepting new patients

Locations

1620 Alpine Blvd
Ste 110
Alpine, CA 91901
Phone (760) 350-9725

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1619040292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 ALPINE BLVD STE 119",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011104",
            "telephone_number": "619-662-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ALPINE BLVD STE 119",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011104",
            "telephone_number": "619-662-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4094 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032143",
            "country_code": "US",
            "telephone_number": "619-515-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDULRAHIM",
        "first_name": "AHMED",
        "middle_name": "MAYET",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "611492736",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699216754",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AHMED",
            "last_name": "ABDULRAHIM",
            "middle_name": "MAYET",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Alpine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.