Georgie Joven Pechulis, M.D,

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A 111809 Issued in CA

Practice address

455 S Main St
Academic Affairs
Orange, CA 92868-3835

Phone

(714) 997-3000

Fax

(714) 289-4010

NPI assigned

Apr 9, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children'S Hospital of Orange County

  • Pediatrics Physician
  • Orange, CA
  • NPI 1275975104
  Medicare reassignment NPD

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1164748521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "address_2": "ACADEMIC AFFAIRS",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-997-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "address_2": "ACADEMIC AFFAIRS",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-997-3000",
            "fax_number": "714-289-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECHULIS",
        "first_name": "GEORGIE",
        "middle_name": "JOVEN",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A 111809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Phyllis Pearson, MD
• Sharnise Pearson
• Simone Pearson
• Jonathan Michael Peaslee
• Spring Medley Peavy, FNP-C
• Martha M Peck, CRNA
• Robert Steven Peck, M.D.
• Pediatric Eye Care & Surgery Medical Corporation
• Pediatric Subspecialty Faculty
• Pediatric Subspecialty Faculty, Inc.

• Pediatrics Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.