NPIMap

Individual provider Active NPI

Kenneth C Wen, MD

  • Cardiovascular Disease Physician
  • Costa Mesa, CA
National Provider Identifier
1003980822
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
231432 Issued in NY
Practice address
3080 Bristol St
Suite 600
Costa Mesa, CA 92626-3093
Phone
(714) 445-0220
Fax
(714) 445-0246
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 231432 NY Primary

Addresses

Primary practice location

3080 Bristol St
Suite 600
Costa Mesa, CA 92626-3093

Mailing address

3080 Bristol St
Suite 600
Costa Mesa, CA 92626-3093
Phone (714) 445-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090910000463 CA Practitioner - Cardiovascular Disease (Cardiology) 9335249226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Cardiovascular Associates Medical Group, Inc.Group PAC ID 3678461209, 23 clinicians

Practice addresses (Care Compare)

681 S Parker St
Suite 100
Orange, CA 92868-4719
Phone (714) 445-0220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.2 of 100Reported as group
Quality
53.01
Promoting interoperability
87
Improvement activities
40
Cost
75.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107067CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Cardiovascular Associates Medical Group, Inc. CurrentSince Jul 20, 2009 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
New York Westchester SQ Med Ctr Past Accepting new patients
Hoag Orthopedic Institute LLC Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

710 N Euclid St
Ste 214
Anaheim, CA 92801
Phone (714) 522-2891

3070 Bristol St
Ste 190
Costa Mesa, CA 92626
Phone (714) 445-0228

3080 Bristol St
Ste 600
Costa Mesa, CA 92626
Phone 7144450228 ext. 8262

11180 Warner Ave
Ste 269
Fountain Vly, CA 92708
Phone (714) 486-1228

24022 Calle de la Plata
Ste 500
Laguna Hills, CA 92653
Phone (877) 430-7337

681 S Parker St
Ste 100
Orange, CA 92868
Phone 7144450228 ext. 8262

724 S El Camino Real
San Clemente, CA 92672
Phone (949) 453-4343

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kenneth.wen@direct.pca.nextgenshare.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 4

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1003980822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 BRISTOL ST",
            "address_2": "SUITE 600",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263093",
            "telephone_number": "714-445-0220",
            "fax_number": "714-445-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 BRISTOL ST",
            "address_2": "SUITE 600",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263093",
            "telephone_number": "714-445-0220",
            "fax_number": "714-445-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEN",
        "first_name": "KENNETH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "231432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.