Individual provider Active NPI

Scott Lester Nelson, PSY.D.

  • Clinical Psychologist
  • Newport Beach, CA
National Provider Identifier
1164551933
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27994 Issued in CA
Practice address
3300 Irvine Ave
Suite 111
Newport Beach, CA 92660-3109
Phone
(949) 229-5480
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY27994 CA Primary

Addresses

Primary practice location

3300 Irvine Ave
Suite 111
Newport Beach, CA 92660-3109

Mailing address

PO Box 27264
Santa Ana, CA 92799-7264
Phone (714) 381-0836

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210219001437 CA Practitioner - Clinical Psychologist 8224206701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chiron Psychological IncGroup PAC ID 9234496308, 15 clinicians

Practice addresses (Care Compare)

18200 Yorba Linda Blvd
Suite 106
Yorba Linda, CA 92886-4006
Phone (714) 646-8034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY27994CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiron Psychological, Inc Clinical CurrentSince Oct 20, 2021 Accepting new patients

Locations

19742 MacArthur Blvd
Ste 100
Irvine, CA 92612
Phone (714) 646-8034

19742 MacArthur Blvd
Ste 125
Irvine, CA 92612
Phone (714) 402-6437

19742 MacArthur Blvd
Ste 135
Irvine, CA 92612
Phone (714) 646-8034

18200 Yorba Linda Blvd
Ste 111
Yorba Linda, CA 92886

18200 Yorba Linda Blvd
Ste 106
Yorba Linda, CA 92886
Phone (714) 646-8034

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1164551933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27264",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927997264",
            "telephone_number": "714-381-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 IRVINE AVE",
            "address_2": "SUITE 111",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603109",
            "telephone_number": "949-229-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SCOTT",
        "middle_name": "LESTER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.