Individual provider Active NPI

Ali Ghazvini, M.D.

  • Internal Medicine Physician
  • Laguna Hills, CA
National Provider Identifier
1104865153
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A80873 Issued in CA
Practice address
23961 Calle de la Magdalena
Ste 430
Laguna Hills, CA 92653-3616
Phone
(949) 716-7700
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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 A80873 CA Primary

Addresses

Primary practice location

23961 Calle de la Magdalena
Ste 430
Laguna Hills, CA 92653-3616

Mailing address

23961 Calle de la Magdalena
Ste 430
Laguna Hills, CA 92653-3616
Phone (949) 716-7700

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
I20031119000984 CA Practitioner - Internal Medicine 5890699128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Hospital & facility affiliations

  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A80873CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients
Southern California Hospitalist Network Medical Group Inc Internal Medicine Past Accepting new patients

Locations

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

23512 Madero
Mission Viejo, CA 92691
Phone (949) 583-1600

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

Interoperability endpoints

  • Direct secure messaging: aghazvinimd15261@direct.memorialcare.org

Organizations & group practices 4

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 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1104865153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA",
            "address_2": "STE 430",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533616",
            "telephone_number": "949-716-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA",
            "address_2": "STE 430",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533616",
            "telephone_number": "949-716-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAZVINI",
        "first_name": "ALI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A80873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.