Individual provider Active NPI

Absalom D Hepner, M.D.

  • Nuclear Cardiology Physician
  • Mission Viejo, CA
National Provider Identifier
1205880994
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Cardiology PhysicianTaxonomy code 207UN0901X
License
A78126 Issued in CA
Practice address
26800 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691-8038
Phone
(949) 364-3570
Fax
(949) 364-3430
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X A78126 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691-8038

Mailing address

26800 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691-8038
Phone (949) 364-3570

Other identifiers 1

IdentifierTypeStateIssuer
00A781260MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahepner1373979@oc.providencedirect.org

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
I20050531000609 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7113969130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of California, Geffen School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78126CAMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents CurrentSince Mar 1, 2016 Accepting new patients
Providence Medical Foundation CurrentSince May 1, 2021 Accepting new patients
UC Regents Current Accepting new patients
Providence Medical Foundation CurrentSince May 1, 2021 Accepting new patients
UC Regents CurrentSince Mar 1, 2016 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
Children's Hospital at Mission Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

26800 Crown Valley Pkwy
Ste 105
Mission Viejo, CA 92691
Phone (949) 364-6053

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

26800 Crown Valley Pkwy
Ste 250
Mission Viejo, CA 92691
Phone (949) 364-3570

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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 5

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1205880994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918038",
            "telephone_number": "949-364-3570",
            "fax_number": "949-364-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918038",
            "telephone_number": "949-364-3570",
            "fax_number": "949-364-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPNER",
        "first_name": "ABSALOM",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "A78126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A781260",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahepner1373979@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.