Individual provider Active NPI

Jason Matthew Kurtz, D.O.

  • Internal Medicine Physician
  • Placentia, CA
National Provider Identifier
1104128552
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A11054 Issued in CA
Practice address
1041 E Yorba Linda Blvd
Ste 209
Placentia, CA 92870
Phone
(714) 831-1844
Fax
(714) 831-1845
NPI assigned
Nov 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A11054 CA Primary

Addresses

Primary practice location

1041 E Yorba Linda Blvd
Ste 209
Placentia, CA 92870

Mailing address

1041 E Yorba Linda Blvd
Ste 209
Placentia, CA 92870
Phone (714) 831-1844

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
I20111111000240 CA Practitioner - Internal Medicine 8426222381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1041 E Yorba Linda Blvd
Suite 209
Placentia, CA 92870-3760
Phone (714) 831-1844

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11054CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1104128552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD",
            "address_2": "STE 209",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "92870",
            "telephone_number": "714-831-1844",
            "fax_number": "714-831-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD",
            "address_2": "STE 209",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "92870",
            "telephone_number": "714-831-1844",
            "fax_number": "714-831-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-17",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A11054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.