NPIMap

Individual provider Active NPI

Ali Mohamad Awada, MD

  • Pediatrics Physician
  • Hawthorne, CA
National Provider Identifier
1992722995
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A76844 Issued in CA
Practice address
11633 Hawthorne Blvd
Suite 100
Hawthorne, CA 90250-2321
Phone
(310) 355-0054
Fax
(310) 355-0293
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A76844 CA Primary

Addresses

Primary practice location

11633 Hawthorne Blvd
Suite 100
Hawthorne, CA 90250-2321

Mailing address

1435 E Sycamore Ave
El Segundo, CA 90245
Phone (310) 355-0054

Other identifiers 2

IdentifierTypeStateIssuer
00A768440MedicaidCA
00A768440OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A76844CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ali M. Awada M.D. Inc. Pediatrics Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJCIBA/Endpoint/DJCIBA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1992722995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 E SYCAMORE AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "90245",
            "telephone_number": "310-355-0054",
            "fax_number": "310-355-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11633 HAWTHORNE BLVD",
            "address_2": "SUITE 100",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502321",
            "telephone_number": "310-355-0054",
            "fax_number": "310-355-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWADA",
        "first_name": "ALI",
        "middle_name": "MOHAMAD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A76844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A768440",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A768440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.