Individual provider Active NPI

Nagui Achamallah, M.D.

  • Psychiatry Physician
  • Modesto, CA
National Provider Identifier
1629057393
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A48988 Issued in CA
Practice address
1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone
(510) 900-3125
NPI assigned
Jan 11, 2006
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A48988 CA Primary

Addresses

Primary practice location

1601 Cummins Dr Ste D
Modesto, CA 95358-6411

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 900-3125

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20070212000444 CA Practitioner - Psychiatry 7719989334 Reassigns benefits to 5 organizations
Practice locations: Thousand Oaks, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance for Wellness IncGroup PAC ID 9931355617, 58 clinicians
Cep America - Psychiatry PCGroup PAC ID 0244522159, 93 clinicians

Practice addresses (Care Compare)

14850 Roscoe Blvd
Panorama City, CA 91402-4618
Phone (818) 787-2222

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone (925) 939-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48988CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
Alliance for Wellness, Inc. Psychiatry CurrentSince Jun 19, 2024 Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Aug 1, 2017 Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Aug 1, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 30, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 22, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cep America - Psychiatry PC Psychiatry Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 30, 2019 Accepting new patients
John Muir Trauma Physicians Billing Service Psychiatry CurrentSince Jul 3, 2007 Accepting new patients
O B Towery MD Inc Past Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Tamika Henry MD Inc PastSince Jan 7, 2025 Accepting new patients

Locations

2740 Grant St
Concord, CA 94520
Phone (925) 518-5844

16260 Ventura Blvd
Ste 630
Encino, CA 91436
Phone (747) 264-9201

2355 23rd St
Eureka, CA 95501
Phone (747) 998-0387

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

14850 Roscoe Blvd
Van Nuys, CA 91402
Phone (818) 787-2222

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2930

Interoperability endpoints

  • Direct secure messaging: nachamallah18399@ehr.johnmuirhealth.com
  • Direct secure messaging: nachamallah814769@oc.providencedirect.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1629057393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-900-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-900-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHAMALLAH",
        "first_name": "NAGUI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2021-12-13",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A48988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.