Jibran A Ahmed

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95020754 Issued in CA

Practice address

4100 Newport Place Dr Ste 730
Newport Beach, CA 92660-1411

Phone

(206) 695-7600

NPI assigned

Sep 16, 2020

Last updated

Nov 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Health Solutions a Professional Medical CorporationGroup PAC ID 3173613973, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jahmed577177@direct.multicare.org

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.

• Mindful Health Solutions a Professional Medical Corporation

  dba TMS Health Solutions

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1881894483
  Medicare reassignment Care Compare group NPD
• Special Service for Groups, Inc.

  • Voluntary or Charitable Agency
  • Los Angeles, CA
  • NPI 1952442949
  Medicare reassignment NPD
• Special Service for Groups, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1669503793
  NPD
• Special Service for Groups, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1982735932
  NPD

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1992311823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 NEWPORT PLACE DR STE 730",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 NEWPORT PLACE DR STE 730",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601411",
            "telephone_number": "206-695-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "JIBRAN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61172870",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020754",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95281954",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60865339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahcs Mission, LLC (Mission Plaza Pharmacy 2)
• Aaron Joseph Ahearn, MD-PHD
• Ahmad Beach Body MD Inc
• Ahmad Beach Skin MD Inc
• Ali Ahmad, M.D.
• Sabah Ahmed, MD
• David Taehyung Ahn, MD
• Jane Ahn
• Soo Ahn
• Nicole Aho

• Psychiatric/Mental Health Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.