NPIMap

Organization Active NPI

Uci Department of Urology

  • Urology Physician
  • Orange, CA
National Provider Identifier
1255398533
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UCI DEPARTMENT OF UROLOGY
Practice address
101 The City Dr S
Orange, CA 92868
Phone
(714) 456-8500
Fax
(714) 456-8572
NPI assigned
Apr 28, 2006
Last updated
Feb 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Uci Health Provider Relations
Title
Ups Provider Relations
Phone
(714) 456-2986

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary
Pediatric Urology Physician 2088P0231X NU

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868

Mailing address

PO Box 51342
Los Angeles, CA 90051-5642
Phone (714) 456-6054

Other identifiers 3

IdentifierTypeStateIssuer
CG7652OtherCARR MEDICARE
GR0085140MedicaidCA
ZZZ54082ZOtherCABLUE SHIELD GRP

Other names 1

  • Regents of the University of California, Irvine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202001148 CA Part B Supplier - Clinic/Group Practice 6901799238 Receives reassigned benefits from 93 practitioners
Practice locations: Corona, CA; Orange, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1255398533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51342",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900515642",
            "telephone_number": "714-456-6054",
            "fax_number": "888-378-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-8500",
            "fax_number": "714-456-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCI DEPARTMENT OF UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "PROVIDER RELATIONS",
        "authorized_official_first_name": "UCI HEALTH",
        "authorized_official_title_or_position": "UPS PROVIDER RELATIONS",
        "authorized_official_telephone_number": "714-456-2986"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG7652",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0085140",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GRP",
            "identifier": "ZZZ54082Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regents of the University of California, Irvine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Regents of the University of California, Irvine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.