Individual provider Active NPI

Jose R. Cilliani, D.O.

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1265545586
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8852 Issued in CA
Practice address
420 S Bristol St
Santa Ana, CA 92703-4527
Phone
(714) 541-5252
Fax
(714) 541-1402
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8852 CA Primary

Addresses

Primary practice location

420 S Bristol St
Santa Ana, CA 92703-4527

Mailing address

420 S Bristol St
Santa Ana, CA 92703-4527
Phone (714) 541-5252

Other identifiers 1

IdentifierTypeStateIssuer
00AX88520MedicaidCA

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
I20120207000507 CA Practitioner - Family Practice 2668639493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Choice Aco IncGroup PAC ID 7719379395, 60 clinicians

Practice addresses (Care Compare)

420 S Bristol St
Santa Ana, CA 92703-4527
Phone (714) 541-5252

7631 Wyoming St
Suite 201
Westminster, CA 92683-3904
Phone (714) 898-0765

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8852CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Choice Aco Inc CurrentSince Jan 1, 2022 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
University of California Irvine Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Locations

7631 Wyoming St
Ste 201
Westminster, CA 92683
Phone (714) 898-0765

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFGFDD/Endpoint/HFGFDD

Organizations & group practices 10

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1265545586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S BRISTOL ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927034527",
            "telephone_number": "714-541-5252",
            "fax_number": "714-541-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S BRISTOL ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927034527",
            "telephone_number": "714-541-5252",
            "fax_number": "714-541-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CILLIANI",
        "first_name": "JOSE",
        "middle_name": "R.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX88520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.