NPIMap

Individual provider Active NPI

Dennis T Jordanides, M.D.

  • Internal Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1285638031
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66293 Issued in CA
Practice address
500 Superior Ave
Suite 135
Newport Beach, CA 92663-3657
Phone
(949) 734-7446
Fax
(949) 734-7448
NPI assigned
Jun 9, 2005
Last updated
Aug 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A66293 CA Primary

Addresses

Primary practice location

500 Superior Ave
Suite 135
Newport Beach, CA 92663-3657

Mailing address

500 Superior Ave Ste 135
Newport Beach, CA 92663-3617
Phone (949) 734-7446

Other identifiers 3

IdentifierTypeStateIssuer
P00471216OtherCAMEDICARE RAIL ROAD
00A66293MedicaidCA
00A66293OtherCABLUE SHEILD OF CALIFORNIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060203000555 CA Practitioner - Internal Medicine 6305804238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

320 Superior Ave
Suite 200
Newport Beach, CA 92663-2741
Phone (949) 734-7446

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66293CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Pulmonary Associates PastSince Nov 1, 1995 Accepting new patients
Inpatient Consultants of Colorado, PC Internal Medicine Past Accepting new patients
University of California Irvine Past Accepting new patients
Inpatient Consultants of Colorado PC Internal Medicine Past Accepting new patients
David J Borchers MD PC Past Accepting new patients
Ann M. Mass, M.D., P.C. Internal Medicine PastSince Jan 1, 2005 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19740/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1285638031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SUPERIOR AVE STE 135",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633617",
            "telephone_number": "949-734-7446",
            "fax_number": "949-734-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SUPERIOR AVE",
            "address_2": "SUITE 135",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633657",
            "telephone_number": "949-734-7446",
            "fax_number": "949-734-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDANIDES",
        "first_name": "DENNIS",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P00471216",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A66293",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD OF CALIFORNIA",
            "identifier": "00A66293",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.