Individual provider Active NPI

Ann Margaret Sevilla Vergel de Dios, DNP

  • Acute Care Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1073106670
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95016694 Issued in CA
Practice address
4255 Campus Dr Ste A100
#5532
Irvine, CA 92612-8650
Phone
(714) 869-7487
NPI assigned
Feb 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95016694 CA Primary
Emergency Registered Nurse 163WE0003X 95049509 CA

Addresses

Primary practice location

4255 Campus Dr Ste A100
#5532
Irvine, CA 92612-8650

Mailing address

2214 Melogold Way
Corona, CA 92883-3191
Phone (714) 390-1336

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310000126 CA Practitioner - Nurse Practitioner 2466868856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orca Rehab IncGroup PAC ID 6901281484, 16 clinicians

Practice addresses (Care Compare)

1010 W la Veta Ave
Orange, CA 92868-4300
Phone (714) 869-7487

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95049509CAMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Orca Rehab Inc CurrentSince Jun 12, 2023 Accepting new patients
Michael Decker, DO, Inc CurrentSince Aug 22, 2023 Accepting new patients
Amirpasha Ehsan MD, Inc Past Accepting new patients

Locations

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

565 Pier Ave
Unit 1352
Hermosa Beach, CA 90254
Phone (816) 896-1355

2725 E Broadway
Long Beach, CA 90803
Phone (562) 434-4494

1010 W La Veta Ave
Orange, CA 92868
Phone (714) 221-1200

4070 Jurupa Ave
Riverside, CA 92506
Phone (949) 239-4410

13522 Newport Ave
Ste 102
Tustin, CA 92780
Phone (714) 573-8200

Organizations & group practices 3

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": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1073106670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 MELOGOLD WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928833191",
            "telephone_number": "714-390-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 CAMPUS DR STE A100",
            "address_2": "#5532",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128650",
            "telephone_number": "714-869-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGEL DE DIOS",
        "first_name": "ANN MARGARET",
        "middle_name": "SEVILLA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-15",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95016694",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "95049509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.