NPIMap

Organization Active NPI

Minuteclinic Diagnostic Medical Group of Orange County Inc

  • Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1104013879
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF ORANGE COUNTY INC
Practice address
14330 Culver Dr
Irvine, CA 92604-0303
Phone
(866) 389-2727
Fax
(401) 406-3539
NPI assigned
Sep 26, 2007
Last updated
Oct 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

14330 Culver Dr
Irvine, CA 92604-0303

Mailing address

PO Box 772
Minuteclinic Credentialing
Woonsocket, RI 02895-0784
Phone (866) 389-2727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090116000214 CA Part B Supplier - Clinic/Group Practice 5991868929 Receives reassigned benefits from 205 practitioners
Practice locations: Irvine, CA; Yorba Linda, CA; Temecula, CA; Seal Beach, CA; San Clemente, CA; Riverside, CA; Rancho Cucamonga, CA; Mission Viejo, CA…

National Provider Directory

National Provider Directory
Tax ID family
Minuteclinic Diagnostic Medical Group of Orange County Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

26891 Aliso Creek Rd
Aliso Viejo, CA 92656
Phone (949) 260-4081

2011 E La Palma Ave
Anaheim, CA 92806
Phone (714) 991-9161

8850 Valley View St
Buena Park, CA 90620
Phone (714) 827-7321

1183 Magnolia Ave
Corona, CA 92879
Phone (951) 272-4427

1150 Baker St
Costa Mesa, CA 92626
Phone (714) 622-7517

32575 Golden Lantern
Dana Point, CA 92629
Phone (949) 248-4803

14220 Schleisman Rd
Eastvale, CA 92880
Phone (951) 340-0875

26686 Portola Pkwy
Foothill Ranch, CA 92610
Phone (949) 470-4630

19121 Beach Blvd
Huntington Beach, CA 92648
Phone (714) 309-7766

3981 Irvine Blvd
Irvine, CA 92602
Phone (714) 338-1603

30842 Coast Hwy
Ste 1
Laguna Beach, CA 92651

21761 Lake Forest Dr
Lake Forest, CA 92630
Phone (949) 855-0144

25272 Marguerite Pkwy
Mission Viejo, CA 92692
Phone (949) 330-5070

1535 E Katella Ave
Orange, CA 92867
Phone (714) 639-6060

21572 Plano Trabuco Rd
Trabuco Canyon, CA 92679
Phone (949) 589-3792

Practitioners & affiliated clinicians

Practitioners 231

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 231

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1104013879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "address_2": "MINUTECLINIC CREDENTIALING",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14330 CULVER DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040303",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC MEDICAL GROUP OF ORANGE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.