Individual provider Active NPI

Chelan Ashley Nour, M.D.

  • Anesthesiology Physician
  • Loma Linda, CA
National Provider Identifier
1881925519
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A114616 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(310) 701-6876
NPI assigned
Jan 20, 2010
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A114616 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

1509 Marion Rd
Redlands, CA 92374-6332
Phone (310) 701-6876

Other names 1

  • Dr. Chelan Ashley Malmberg Former name

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
I20120820000810 CA Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 6901053313 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 823-8911

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A114616CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 20, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 20, 2020 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince May 1, 2022 Accepting new patients
Westside Anesthesia Services Anesthesiology CurrentSince Oct 1, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Loma Linda Univ Anesthesiology Medical Group Inc Anesthesiology Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

120 S Spalding Dr
Ste 115
Beverly Hills, CA 90212
Phone (310) 385-7755

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

6801 Park Ter
Ste 300
Los Angeles, CA 90045
Phone (310) 655-7200

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

3501 Jamboree Rd
Ste 1200
Newport Beach, CA 92660
Phone (949) 988-7800

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 264-2561

Organizations & group practices 7

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1881925519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 MARION RD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923746332",
            "telephone_number": "310-701-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "310-701-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOUR",
        "first_name": "CHELAN",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A114616",
            "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": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHELAN",
            "last_name": "MALMBERG",
            "middle_name": "ASHLEY",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.