Individual provider Active NPI

Marwa Nevenna Ahady, PA-C

  • Physician Assistant
  • El Monte, CA
National Provider Identifier
1881280113
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58888 Issued in CA
Practice address
12100 Valley Blvd Ste 109a
El Monte, CA 91732-3161
Phone
(626) 575-7500
Fax
(626) 575-1956
NPI assigned
Dec 21, 2020
Last updated
Sep 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 58888 CA Primary

Addresses

Primary practice location

12100 Valley Blvd Ste 109a
El Monte, CA 91732-3161

Mailing address

12100 Valley Blvd # 190a
El Monte, CA 91732-3100
Phone (626) 575-7500

Other practice location 1

696 Hampshire Rd Ste 110
Westlake Village, CA 91361-4456
Phone (805) 725-6414

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210202000749 CA Practitioner - Physician Assistant 1355755463 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin and Beauty Center IncGroup PAC ID 8628170347, 34 clinicians

Practice addresses (Care Compare)

696 Hampshire Rd
Suite 110
Westlake Village, CA 91361-4456
Phone (818) 842-8000

9535 Reseda Blvd
Suite 304
Northridge, CA 91324-6029
Phone (818) 886-3884

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Promoting interoperability
90
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58888CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Skin and Beauty Center Inc CurrentSince Oct 6, 2025 Accepting new patients
Northridge Dermatology Associates Medical Group Inc Current Accepting new patients
Skin and Beauty Center (SBC), Inc. CurrentSince Oct 6, 2025 Accepting new patients

Locations

191 S Buena Vista St
Ste 475
Burbank, CA 91505
Phone (818) 322-0126

9535 Reseda Blvd
Ste 304
Northridge, CA 91324
Phone (818) 886-3884

696 Hampshire Rd
Ste 110
Westlake Vlg, CA 91361
Phone (805) 230-1111

Interoperability endpoints

  • Direct secure messaging: marwaa@doctordermatology.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1881280113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 VALLEY BLVD # 190A",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323100",
            "telephone_number": "626-575-7500",
            "fax_number": "626-575-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 VALLEY BLVD STE 109A",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323161",
            "telephone_number": "626-575-7500",
            "fax_number": "626-575-1956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "696 Hampshire Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Westlake Village",
            "state": "CA",
            "postal_code": "913614456",
            "country_code": "US",
            "telephone_number": "805-725-6414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHADY",
        "first_name": "MARWA",
        "middle_name": "NEVENNA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.