Individual provider Active NPI

Ahmad Edris, M.D.

  • Interventional Cardiology Physician
  • Monterey, CA
National Provider Identifier
1689890808
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A98251 Issued in CA
Practice address
30 Garden CT
Monterey, CA 93940-5302
Phone
(831) 647-1123
Fax
(831) 886-3647
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A98251 CA
Interventional Cardiology Physician 207RI0011X A98251 CA Primary

Addresses

Primary practice location

30 Garden CT
Monterey, CA 93940-5302

Mailing address

100 Wilson Rd Ste 100
Monterey, CA 93940-7885
Phone (831) 649-1000

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
I20091030000261 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear MedicinePractitioner - Internal Medicine 2264579820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine, Nuclear Medicine
Education
University of California, Irvine, California College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montage Medical GroupGroup PAC ID 6406901941, 125 clinicians

Practice addresses (Care Compare)

30 Garden CT
B
Monterey, CA 93940-5302
Phone (831) 647-1123

Hospital & facility affiliations

  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

Merit-based Incentive Payment System (MIPS)

Final score
86.59 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
73.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting43
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula CurrentSince Feb 1, 2023 Accepting new patients
Montage Medical Group CurrentSince Feb 1, 2023 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Feb 1, 2023 Accepting new patients

Locations

23845 Holman Hwy
Ste 109
Monterey, CA 93940
Phone (415) 353-7449

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

30 Garden Ct
Monterey, CA 93940
Phone (831) 646-8570

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

30 Garden Ct
#B
Monterey, CA 93940
Phone (831) 647-1123

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1689890808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-649-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 GARDEN CT",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405302",
            "telephone_number": "831-647-1123",
            "fax_number": "831-886-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDRIS",
        "first_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A98251",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A98251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.