Individual provider Active NPI

Basil O Ike Jr.

  • Sports Medicine (Family Medicine) Physician
  • Orange, CA
National Provider Identifier
1114553146
Registry record updated May 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A19702 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(999) 999-9999
NPI assigned
Mar 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 20A19702 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

200 S Manchester Ave Ste 835
Orange, CA 92868-3213

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
I20240917004404 CA Practitioner - Family PracticePractitioner - Sports Medicine 3173973914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University ofGroup PAC ID 3779689518, 30 clinicians
University of California IrvineGroup PAC ID 5395658181, shared by 9 NPIs, 57 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8068

2441 W la Palma Ave
Anaheim, CA 92801-2658
Phone (657) 282-6356

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.4 of 100Reported as group
Quality
93.75
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19702CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of CurrentSince Nov 1, 2025 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

2441 W La Palma Ave
Ste 100
Anaheim, CA 92801
Phone (657) 282-6356

2161 San Joaquin Hills Rd
Ste 100
Newport Beach, CA 92660

2161 San Joaquin Hills Rd
Newport Beach, CA 92660
Phone (949) 386-5700

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

200 S Manchester Ave
Ste 835
Orange, CA 92868
Phone (714) 456-8265

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778371200000",
    "number": "1114553146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 835",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683213",
            "fax_number": "800-465-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKE",
        "first_name": "BASIL",
        "middle_name": "O",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-21",
        "last_updated": "2026-05-10",
        "certification_date": "2026-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A19702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.