Individual provider Active NPI

Michael Kermani, MD

  • Ophthalmology Physician
  • Newport Beach, CA
National Provider Identifier
1013010685
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A75009 Issued in CA
Practice address
1441 Avocado Ave
501
Newport Beach, CA 92660-7721
Phone
(949) 836-1690
Fax
(949) 640-2090
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A75009 CA Primary

Addresses

Primary practice location

1441 Avocado Ave
501
Newport Beach, CA 92660-7721

Mailing address

P O Box 10711
Newport Beach, CA 92658
Phone (949) 836-1690

Other identifiers 1

IdentifierTypeStateIssuer
00A750090MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040826000806 CA Practitioner - Ophthalmology 7719952571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Pittsburgh School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1441 Avocado Ave
Suite 501
Newport Beach, CA 92660-7706
Phone (949) 640-2010

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75009CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Kermani, MD, Inc Ophthalmology CurrentSince Jan 1, 2005 Accepting new patients
Hoag Memorial Hospital Presbyterian PastSince Jan 1, 2005 Accepting new patients

Locations

27001 La Paz Rd
Ste 401A
Mission Viejo, CA 92691
Phone (949) 380-9800

1441 Avocado Ave
Ste 501
Newport Beach, CA 92660
Phone (949) 640-2010

Organizations & group practices 2

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1013010685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 10711",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92658",
            "telephone_number": "949-836-1690",
            "fax_number": "949-640-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE",
            "address_2": "501",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607721",
            "telephone_number": "949-836-1690",
            "fax_number": "949-640-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERMANI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A75009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A750090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.