Individual provider Active NPI

Joseph Gregurich, M.D.

  • Family Medicine Physician
  • Fountain Valley, CA
National Provider Identifier
1154416279
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G20621 Issued in CA
Practice address
11100 Warner Ave
Ste 112
Fountain Valley, CA 92708-7500
Phone
(714) 556-8320
Fax
(714) 556-5417
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G20621 CA Primary

Addresses

Primary practice location

11100 Warner Ave
Ste 112
Fountain Valley, CA 92708-7500

Mailing address

11100 Warner Ave
Ste 112
Fountain Valley, CA 92708-7500
Phone (714) 556-8320

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
I20040302000417 CA Practitioner - Family Practice 2466349766 Reassigns benefits to 1 organization
Practice locations: Fountain Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Choice Aco IncGroup PAC ID 7719379395, 60 clinicians

Practice addresses (Care Compare)

11100 Warner Ave
Suite 112
Fountain Valley, CA 92708-7500
Phone (714) 556-8320

7631 Wyoming St
Suite 201
Westminster, CA 92683-3904

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G20621CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Choice Aco Inc CurrentSince Jan 1, 2022 Accepting new patients
Pacific DX Idtf Family Medicine Past Accepting new patients
Pacific Diagnostics Family Medicine Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients

Locations

7631 Wyoming St
Ste 201
Westminster, CA 92683
Phone (714) 898-0765

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1154416279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "STE 112",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087500",
            "telephone_number": "714-556-8320",
            "fax_number": "714-556-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "STE 112",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087500",
            "telephone_number": "714-556-8320",
            "fax_number": "714-556-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGURICH",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G20621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.