Individual provider Active NPI

Betty S Ahn, MD

  • Emergency Medicine Physician
  • Pasadena, CA
National Provider Identifier
1902862089
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A77991 Issued in CA
Practice address
100 W California Blvd
Pasadena, CA 91105-3010
Phone
(626) 397-3445
Fax
(626) 397-5643
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A77991 CA Primary

Addresses

Primary practice location

100 W California Blvd
Pasadena, CA 91105-3010

Mailing address

PO Box 60259
Los Angeles, CA 90060-0259
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
00A779910MedicaidCA

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
I20040727000919 CA Practitioner - Emergency Medicine 3375513542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Southern California Keck School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Viejo Emergency Medical Associates, Inc.Group PAC ID 7315090271, 28 clinicians

Practice addresses (Care Compare)

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 118-5200

Hospital & facility affiliations

  • Cedar-Sinai Marina del Rey Hospital Hospital, Marina del Rey, CA, CCN 050740

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A77991CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Oaks Emergency Medical Associates Emergency Medicine CurrentSince Jan 1, 2006 Accepting new patients
Mission Viejo Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Golden State Emergency Physicians Inc Emergency Medicine Past Accepting new patients
California Em-I Medical Services, a Medical Corporation Emergency Medicine Past Accepting new patients
HMH Emergency Medical Group, Inc. Emergency Medicine Past Accepting new patients
Phalarope Inpatient Services, a Medical Corporation Past Accepting new patients
Los Robles Emergency Physicians Medical Group Emergency Medicine PastSince Mar 12, 2023 Accepting new patients
Northridge Emergency Medical Group Emergency Medicine Past Accepting new patients

Locations

31872 Coast Hwy
Laguna Beach, CA 92651
Phone (949) 499-1311

4929 Van Nuys Blvd
Van Nuys, CA 91403
Phone (818) 907-4561

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 577-5505

Interoperability endpoints

  • Direct secure messaging: bahn@exer.direct.codonix.com

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.

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1902862089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60259",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900600259",
            "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": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-3445",
            "fax_number": "626-397-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "BETTY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A77991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A779910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.