Individual provider Active NPI

David L Wirta, MD

  • Ophthalmology Physician
  • Newport Beach, CA
National Provider Identifier
1255435822
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G81350 Issued in CA
Practice address
520 Superior Ave Ste 235
Newport Beach, CA 92663-3642
Phone
(949) 650-1863
Fax
(949) 650-4359
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G81350 CA Primary

Addresses

Primary practice location

520 Superior Ave Ste 235
Newport Beach, CA 92663-3642

Mailing address

1501 Superior Ave
Suite 303
Newport Beach, CA 92663
Phone (949) 650-1863

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
I20101209000875 CA Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 7911194402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
University of California, Geffen School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David L Wirta MD IncGroup PAC ID 9931396421, 2 clinicians

Practice addresses (Care Compare)

520 Superior Ave
Suite 235
Newport Beach, CA 92663-3642
Phone (949) 650-1863

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G81350CAMDOphthalmology Physician

Practice roles (7 of 8)

OrganizationSpecialtyStatusNew patients
David Wirta M D Inc CurrentSince Oct 18, 2010 Accepting new patients
Aisthetikos, Inc PastSince Apr 19, 2009 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

1501 Superior Ave
Ste 303
Newport Beach, CA 92663
Phone (949) 642-7600

520 Superior Ave
Ste 235
Newport Beach, CA 92663
Phone (949) 650-1863

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1255435822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE",
            "address_2": "SUITE 303",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-650-1863",
            "fax_number": "949-650-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 235",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633642",
            "telephone_number": "949-650-1863",
            "fax_number": "949-650-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTA",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G81350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.