Jeffrey Stuart Illeck, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G067729 Issued in CA

Practice address

19582 Beach Blvd Ste 202
Huntington Beach, CA 92648-2996

Phone

(714) 841-9899

Fax

(714) 841-2729

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
• Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jeffrey.illeck.p67@direct.nautilus.nextgenshare.com

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.

• Hoag Clinic

  • Primary Care Clinic/Center
  • Newport Beach, CA
  • NPI 1942799523
  Medicare reassignment Care Compare group NPD
• Magella Medical Group, Inc.

  • Maternal & Fetal Medicine Physician
  • Long Beach, CA
  • NPI 1376640086

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Hoag Hospital

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1689864365
  NPD (past)
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  Care Compare affiliation

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554508800000",
    "number": "1013920958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19582 BEACH BLVD STE 202",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482996",
            "telephone_number": "714-841-9899",
            "fax_number": "714-841-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19582 BEACH BLVD STE 202",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482996",
            "telephone_number": "714-841-9899",
            "fax_number": "714-841-2729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Superior Ave Ste 330",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926633658",
            "country_code": "US",
            "telephone_number": "949-438-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILLECK",
        "first_name": "JEFFREY",
        "middle_name": "STUART",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G067729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Matthew Elijah Ikeda, PT, DPT
• Mellany Javier Ilagan-Adamson, PT
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• Chad Allan Infante, PTA

• Obstetrics & Gynecology Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.