NADINE M HAMMOUD (DO, MS) – Addiction Medicine (Family Medicine) Physician, NPI 1114489598

NADINE M HAMMOUD (DO, MS) is a healthcare provider. based in Moreno valley, California. specializing in ADDICTION MEDICINE, FAMILY PRACTICE. They hold the professional credentials DO, MS. They hold a License No. 20A19668 (CA). The NPI Number for NADINE M HAMMOUD (DO, MS) is 1114489598

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
NADINE M HAMMOUD (DO, MS)
NPI
1114489598
Phone
Not provided
Address
12815 HEACOCK ST
Enumeration Date
3 April 2019
Last Update Date
29 June 2023

Doctor Profile

Medical School Name
ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Secondary Phone
8669847483
Graduation Year
2019 (7 years ago)
PAC ID
5496153777
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20230821003329
Address ID
CA925533116MO12815STXX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness85
Years active:7State licenses:1Other namesUpdated within 12 months

267 ADDICTION MEDICINE in CA

Provider Addresses for NADINE M HAMMOUD (DO, MS)

  • 12815 HEACOCK ST

    MORENO VALLEY, CA 925533116

    Phone:

    Type: Mailing

  • East 4th Street, Santa Ana, Orange County, California, 92869, United States

    SANTA ANA, CA 927053910

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230821003329IAddiction MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92553)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

Does NADINE M HAMMOUD (DO, MS) have a public NPI I can cite?
Public records show NADINE M HAMMOUD (DO, MS) under NPI 1114489598.
Is NADINE M HAMMOUD (DO, MS)'s NPI status active today?
Active status means NADINE M HAMMOUD (DO, MS)'s NPI record is not deactivated in the public file.
What type of care does NADINE M HAMMOUD (DO, MS) provide?
NADINE M HAMMOUD (DO, MS)'s profile centers on Addiction Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to NADINE M HAMMOUD (DO, MS)?
NADINE M HAMMOUD (DO, MS) shows a connection to Moreno Valley, California in registry-derived data.
Who maintains NADINE M HAMMOUD (DO, MS)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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