Individual provider Active NPI

Carla Suzanne Wells, M.D.

  • Obstetrics & Gynecology Physician
  • Irvine, CA
National Provider Identifier
1184787046
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G80278 Issued in CA
Practice address
4050 Barranca Pkwy Ste 200
Irvine, CA 92604-1723
Phone
(949) 559-1911
Fax
(949) 559-4071
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G80278 CA Primary
Specialist 174400000X G80278 CA

Addresses

Primary practice location

4050 Barranca Pkwy Ste 200
Irvine, CA 92604-1723

Mailing address

4050 Barranca Pkwy Ste 200
Irvine, CA 92604-1723
Phone (949) 559-1911

Other identifiers 1

IdentifierTypeStateIssuer
00G802780MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://fhir.memorialcare.org/fhir/api/FHIR/R4 Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20041025000819 CA Practitioner - Obstetrics/Gynecology 6901867936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Saint Louis University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

4050 Barranca Pkwy
Suite 200
Irvine, CA 92604-1723
Phone (949) 551-1090

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Hospital & facility affiliations

  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G80278CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Obstetrics & Gynecology CurrentSince Dec 17, 2020 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

62 Corporate Park
Ste 100
Irvine, CA 92606
Phone (949) 559-1911

4050 Barranca Pkwy
Ste 200
Irvine, CA 92604
Phone (949) 551-1090

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cwells641651@direct.memorialcare.org

Organizations & group practices 5

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 1

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1184787046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 BARRANCA PKWY STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926041723",
            "telephone_number": "949-559-1911",
            "fax_number": "949-559-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 BARRANCA PKWY STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926041723",
            "telephone_number": "949-559-1911",
            "fax_number": "949-559-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "CARLA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G80278",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G80278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G802780",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.memorialcare.org/fhir/api/FHIR/R4",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.