Individual provider Active NPI

Ian Ahwah, M.D.

  • Emergency Medicine Physician
  • Vallejo, CA
National Provider Identifier
1699795146
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G68731 Issued in CA
Practice address
300 Hospital Dr
Vallejo, CA 94589-2574
Phone
(707) 554-4444
Fax
(707) 617-7717
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 8

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.

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: General Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urgent Care Plus Telehealth Inc 27 clinicians

Practice addresses (Care Compare)

1387 E 2ND St
Benicia, CA 94510-2836
Phone (707) 377-1005

2360 1St St
Napa, CA 94559-2239
Phone (707) 377-1007

440 E Washington St
Suite D
Petaluma, CA 94952-5923
Phone (707) 940-5005

446 W Napa St
Sonoma, CA 95476-6519
Phone (707) 690-5332

Merit-based Incentive Payment System (MIPS)

Final score
90.64 of 100Reported as individual
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue16

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
I20071213000505 CA Practitioner - Emergency MedicinePractitioner - General Practice 3173613239 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G68731CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Aug 20, 1998 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Aug 20, 1998 Accepting new patients
Cep America - California Emergency Medicine Past Accepting new patients
Urgent Care Plus Telehealth Inc Emergency Medicine Past Accepting new patients
Urgent Care Plus Telehealth Inc Emergency Medicine Past Accepting new patients

Locations

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

900 Hyde St
San Francisco, CA 94109
Phone (415) 353-6000

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

2000 Vale Rd
San Pablo, CA 94806
Phone (510) 235-7000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G68731 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

300 Hospital Dr
Vallejo, CA 94589-2574

Mailing address

PO Box 661597
Arcadia, CA 91066-1597
Phone (626) 447-0296

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00G687310MedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2008.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1699795146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661597",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910661597",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892574",
            "telephone_number": "707-554-4444",
            "fax_number": "707-617-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHWAH",
        "first_name": "IAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G68731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G687310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.