Individual provider Active NPI

Elizabeth Upson, FNP

  • Family Nurse Practitioner
  • Newport Beach, CA
National Provider Identifier
1073249199
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022048 Issued in CA
Practice address
20311 SW Birch St Ste 200
Newport Beach, CA 92660-1755
Phone
(949) 301-8901
NPI assigned
Jul 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95022048 CA Primary

Addresses

Primary practice location

20311 SW Birch St Ste 200
Newport Beach, CA 92660-1755

Mailing address

20311 SW Birch St Ste 200
Newport Beach, CA 92660-1755
Phone (949) 301-8901

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
I20220906002732 CA Practitioner - Nurse Practitioner 1557745858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95022048CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince Aug 20, 2022 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

31001 Rancho Viejo Rd
Ste 200
San Juan Capistrano, CA 92675
Phone (949) 661-9600

Interoperability endpoints

  • Direct secure messaging: eupson747246@direct.memorialcare.org

Organizations & group practices 1

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": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717200000000",
    "number": "1073249199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20311 SW BIRCH ST STE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601755",
            "telephone_number": "949-301-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20311 SW BIRCH ST STE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601755",
            "telephone_number": "949-301-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPSON",
        "first_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.