Individual provider Active NPI

Azin Meshkinpour, M.D., M.P.H.

  • Dermatology Physician
  • Lake Forest, CA
National Provider Identifier
1205802089
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A75894 Issued in CA
Practice address
24432 Muirlands Blvd
Suite 219
Lake Forest, CA 92630-3939
Phone
(949) 770-8115
Fax
(949) 770-2017
NPI assigned
Feb 23, 2006
Last updated
Dec 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A75894 CA Primary

Addresses

Primary practice location

24432 Muirlands Blvd
Suite 219
Lake Forest, CA 92630-3939

Mailing address

24432 Muirlands Blvd
Suite 219
Lake Forest, CA 92630-3939
Phone (949) 770-8115

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
I20050803000836 CA Practitioner - Dermatology 2668400201 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Irvine, California College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kim Tang MD IncGroup PAC ID 0749699080, 5 clinicians

Practice addresses (Care Compare)

23832 Rockfield Blvd
Suite 210
Lake Forest, CA 92630-2876
Phone 9497708115121

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
85.17 of 100Reported as group
Quality
74.51
Promoting interoperability
92
Improvement activities
40
Cost
82.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision41
Removal of skin lesions1054
Removal of skin cancer86
Removal or shaving of skin growth1-10
Skin biopsy191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75894CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Tang, M.D., Inc. CurrentSince Jul 1, 2021 Accepting new patients
J Robert West, M.D., Inc Dermatology CurrentSince Aug 20, 2018 Accepting new patients
Lorrie J Klein MD Apc Dermatology PastSince Oct 1, 2003 Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Nissan Pilest, MD Inc Past Accepting new patients

Locations

30201 Golden Lantern
Ste B
Laguna Niguel, CA 92677
Phone (949) 363-1788

23832 Rockfield Blvd
Ste 210
Lake Forest, CA 92630
Phone (949) 770-8115

1401 Avocado Ave
Ste 703
Newport Beach, CA 92660
Phone (949) 751-6683

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1205802089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24432 MUIRLANDS BLVD",
            "address_2": "SUITE 219",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303939",
            "telephone_number": "949-770-8115",
            "fax_number": "949-770-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24432 MUIRLANDS BLVD",
            "address_2": "SUITE 219",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303939",
            "telephone_number": "949-770-8115",
            "fax_number": "949-770-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESHKINPOUR",
        "first_name": "AZIN",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A75894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

Verify at the official NPI Registry.