NPIMap

Individual provider Active NPI

Glenn Chiang, M.D.

  • Nephrology Physician
  • Newport Beach, CA
National Provider Identifier
1285697227
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G80417 Issued in CA
Practice address
520 Superior Ave
Suite 340
Newport Beach, CA 92663-3637
Phone
(949) 631-9215
Fax
(949) 631-4576
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G80417 CA Primary

Addresses

Primary practice location

520 Superior Ave
Suite 340
Newport Beach, CA 92663-3637

Mailing address

705 W la Veta Ave
Ste 107
Orange, CA 92868-4447
Phone (714) 639-4901

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
I20100309000152 CA Practitioner - NephrologyPractitioner - Internal Medicine 9032295845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Saint Louis University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Specialists Medical Group, Inc.Group PAC ID 4981780798, 5 clinicians

Practice addresses (Care Compare)

520 Superior Ave
Suite 340
Newport Beach, CA 92663-3674
Phone (949) 631-9215

Hospital & facility affiliations

  • FMC-Newport Superior Dialysis Dialysis facility, Newport Beach, CA, CCN 552755
  • FMC-Newport Mesa Dialysis Services Dialysis facility, Costa Mesa, CA, CCN 552631
  • Rai - Laguna Canyon - Irvine Dialysis facility, Irvine, CA, CCN 052898
  • DaVita Costa Mesa Dialysis Dialysis facility, Costa Mesa, CA, CCN 552518
  • Hoag Home Health Home health agency, Newport Beach, CA, CCN 557412
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G80417CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital of Orange Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 7

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1285697227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W LA VETA AVE",
            "address_2": "STE 107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684447",
            "telephone_number": "714-639-4901",
            "fax_number": "714-771-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE",
            "address_2": "SUITE 340",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633637",
            "telephone_number": "949-631-9215",
            "fax_number": "949-631-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G80417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.