Individual provider Active NPI

John S Belville, M.D.

  • Diagnostic Radiology Physician
  • Fountain Valley, CA
National Provider Identifier
1114978277
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G65179 Issued in CA
Practice address
17100 Euclid St
Radiology Department
Fountain Valley, CA 92708-4004
Phone
(714) 966-7200
Fax
(714) 966-8039
NPI assigned
May 13, 2006
Last updated
Nov 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G65179 CA Primary

Addresses

Primary practice location

17100 Euclid St
Radiology Department
Fountain Valley, CA 92708-4004

Mailing address

PO Box 3148
Mission Viejo, CA 92690-1148
Phone (949) 348-1105

Other identifiers 2

IdentifierTypeStateIssuer
00G651790OtherCABLUE SHIELD OF CA
00G651790MedicaidCA

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
I20040116000809 CA Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 4789583014 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Irvine, California College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport Diagnostic Radiology IncGroup PAC ID 3870494388, 9 clinicians
Newport Diagnostic Center IncGroup PAC ID 4587198379, 8 clinicians

Practice addresses (Care Compare)

1605 Avocado Ave
Newport Beach, CA 92660-7725
Phone (949) 760-3025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Diagnostic Radiology, Inc Diagnostic Radiology CurrentSince Aug 30, 2016 Accepting new patients
Golden State Imaging Associates Inc Diagnostic Radiology CurrentSince Apr 1, 2020 Accepting new patients
UC Regents Diagnostic Radiology CurrentSince Jul 12, 2023 Accepting new patients
Newport Diagnostic Center Inc CurrentSince Oct 1, 2024 Accepting new patients
Quantum Medical Radiology PC Diagnostic Radiology Past Accepting new patients
Digital & Radiologic Imaging Associates Inc. a Medical Group Diagnostic Radiology Past Accepting new patients

Locations

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

17100 Euclid St
Fountain Vly, CA 92708
Phone (714) 966-7200

17100 Euclid St
Ste 4004
Fountain Vly, CA 92708
Phone (714) 966-7200

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

47111 Monroe St
#1112
Indio, CA 92201

6601 White Feather Rd
Joshua Tree, CA 92252
Phone (760) 366-1500

31872 Coast Hwy
Laguna Beach, CA 92651
Phone (949) 499-1311

3700 South St
Lakewood, CA 90712
Phone (562) 424-2900

1605 Avocado Ave
Newport Beach, CA 92660
Phone (949) 760-3025

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

38600 Medical Center Dr
Palmdale, CA 93551
Phone (661) 382-5000

825 N 10th St
Santa Paula, CA 93060
Phone (805) 933-8600

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1114978277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3148",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926901148",
            "telephone_number": "949-348-1105",
            "fax_number": "949-348-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084004",
            "telephone_number": "714-966-7200",
            "fax_number": "714-966-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELVILLE",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G65179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00G651790",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G651790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.