Individual provider Active NPI

Ajanta Naidu, M.D.

  • Pediatric Endocrinology Physician
  • Orange, CA
National Provider Identifier
1093795684
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
A41593 Issued in CA
Practice address
Uci Medical Center
101 The City Drive, Pavillion 1
Orange, CA 92868
Phone
(714) 456-7011
Fax
(714) 456-7857
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X A41593 CA Primary

Addresses

Primary practice location

Uci Medical Center
101 The City Drive, Pavillion 1
Orange, CA 92868

Mailing address

26 Headland Dr
Rancho Palos Verdes, CA 90275-5117
Phone (310) 989-0713

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
I20040210000300 CA Practitioner - EndocrinologyPractitioner - Pediatric Medicine 7315831534 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41593CAMDPharmacist
A41593CAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents CurrentSince Aug 18, 2015 Accepting new patients
UC Regents Current Accepting new patients
UC Regents Uci Dept of Pediatrics CurrentSince Nov 25, 2015 Accepting new patients
UC Regents CurrentSince Aug 18, 2015 Accepting new patients
University of California Irvine Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients
Mission Hospitals, Inc Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
Renuka Boyapalli M D a Medical Corporation PastSince Feb 1, 2007 Accepting new patients

Locations

2100 Medical Plz Dr
Irvine, CA 92697
Phone (949) 824-7246

19200 Jamboree Rd
Ste 2000
Irvine, CA 92612
Phone (949) 898-6000

Gottschalk Medical Plz
Irvine, CA 92697

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

101 The City Dr S
#1
Orange, CA 92868
Phone (714) 456-7011

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198454400000",
    "number": "1093795684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 HEADLAND DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755117",
            "telephone_number": "310-989-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCI MEDICAL CENTER",
            "address_2": "101 THE CITY DRIVE, PAVILLION 1",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-7011",
            "fax_number": "714-456-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "AJANTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "A41593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.