Individual provider Active NPI

Ahmad Khedraki, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1831728724
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A185457 Issued in CA
Practice address
8019 S. Compton Ave
Los Angeles, CA 90001
Phone
(323) 586-7333
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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 A185457 CA Primary

Addresses

Primary practice location

8019 S. Compton Ave
Los Angeles, CA 90001

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801

Other practice location 1

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-2186

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
I20241204003147 CA Practitioner - Psychiatry 5092241778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance for Wellness IncGroup PAC ID 9931355617, 58 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A185457CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance for Wellness, Inc. Psychiatry CurrentSince Oct 14, 2024 Accepting new patients
Tamika Henry MD Inc PastSince Jan 7, 2025 Accepting new patients

Locations

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

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

9250 Reseda Blvd
Ste 658
Northridge, CA 91324

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

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1831728724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 S. COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-586-7333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHEDRAKI",
        "first_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A185457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.