NPIMap

Organization Active NPI

Geiss Med Nevada PC

  • Family Medicine Physician
  • Orange, CA
National Provider Identifier
1033793963
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GEISS MED NEVADA PC
Practice address
2592 N Santiago Blvd
Orange, CA 92867-1862
Phone
(855) 434-7763
NPI assigned
May 6, 2021
Last updated
May 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Authorized official

Name
John Mark Geiss, DONPI 1053651497
Title
Doctor/Owner
Phone
(855) 434-7763

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2592 N Santiago Blvd
Orange, CA 92867-1862

Mailing address

2592 N Santiago Blvd
Orange, CA 92867-1862
Phone (855) 434-7763

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL gmail

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220411002560 NV Part B Supplier - Clinic/Group Practice 8921400599 Receives reassigned benefits from 28 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1088 SW 4TH Ave Ste 1
Ontario, OR 97914

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620604800000",
    "number": "1033793963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 N SANTIAGO BLVD",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928671862",
            "telephone_number": "855-434-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 N SANTIAGO BLVD",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928671862",
            "telephone_number": "855-434-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEISS MED NEVADA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "GEISS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "855-434-7763",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "gmail",
            "affiliation": "N",
            "address_1": "2592 N Santiago Blvd",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928671862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.