Individual provider Active NPI

Ali Elahi, MD

  • Neurology Physician
  • Corona del Mar, CA
National Provider Identifier
1619983533
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A86267 Issued in CA
Practice address
2121 E Coast Hwy Ste 260
Corona del Mar, CA 92625-1932
Phone
(949) 652-7301
Fax
(949) 652-7301
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A86267 CA Primary

Addresses

Primary practice location

2121 E Coast Hwy Ste 260
Corona del Mar, CA 92625-1932

Mailing address

2121 E Coast Hwy Ste 260
Corona del Mar, CA 92625-1932
Phone (949) 652-7301

Other identifiers 1

IdentifierTypeStateIssuer
OOA862670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2019 through Jan 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86267CAMDMarriage & Family Therapist
A86267CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurospa Brain Rejuvenation Center, Inc. Neurology Current Accepting new patients
Mahmoud a. Kreidie Neurology Past Accepting new patients
Chiron Psychological, Inc PastSince Oct 1, 2021 Accepting new patients
American Hearing & Balance Centers, Inc. Past Accepting new patients

Locations

2121 E Coast Hwy
Ste 260
Corona del Mar, CA 92625
Phone (949) 644-2442

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1619983533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY STE 260",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251932",
            "telephone_number": "949-652-7301",
            "fax_number": "949-652-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY STE 260",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251932",
            "telephone_number": "949-652-7301",
            "fax_number": "949-652-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAHI",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A86267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOA862670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

Verify at the official NPI Registry.