DR. EBA H HATHOUT (M.D.) – Pediatrics Physician, NPI 1487674792
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. EBA H HATHOUT (M.D.)
54701 FILE NUMBER
LOS ANGELES, CA 900744701
Phone: (909) 558-3111
Type: Mailing
300 LONGWOOD AVE
BOSTON, MA 021155724
Phone: (617) 355-6000
Type: Mailing
11370, Anderson Street, Loma Linda, San Bernardino County, California, 92354, United States
STE B-100
LOMA LINDA, CA 923543450
Phone: (909) 558-2848
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $179.
Total Amount is formed as General ($179) + Research ($0) + Ownership ($0) = $179.
Last reported payment date: 2024-12-30 • Largest payer in this snapshot: Dexcom, Inc. ($179).
Total Amount
$179
General + Research + Ownership
Payments
21
Total payment records
General Amount
$179
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $179 |
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: 2022-10-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050718000952 | I | Pediatric Medicine | CA | TBD |
| I20221024001544 | I | Endocrinology | MA | TBD |
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.
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 90074)
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Reviews
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