Individual provider Active NPI

Stephen Hamilton Mott, M.D.

  • Neurodevelopmental Disabilities Physician
  • Santa Ana, CA
National Provider Identifier
1295723450
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurodevelopmental Disabilities PhysicianTaxonomy code 2084P0005X
License
C150674 Issued in CA
Practice address
2500 Redhill Ave Ste 100
Santa Ana, CA 92705-5518
Phone
(949) 267-0400
Fax
(949) 221-0004
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 18892 DC
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 14663 NH
Neurodevelopmental Disabilities Physician 2084P0005X 14663 NH
Neurodevelopmental Disabilities Physician 2084P0005X 18892 DC
Neurodevelopmental Disabilities Physician 2084P0005X C150674 CA Primary

Addresses

Primary practice location

2500 Redhill Ave Ste 100
Santa Ana, CA 92705-5518

Mailing address

2500 Redhill Ave Ste 100
Santa Ana, CA 92705-5518
Phone (949) 267-0400

Other identifiers 3

IdentifierTypeStateIssuer
1295723450MedicaidCA
1016783MedicaidVT
30209003MedicaidNH

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
I20170914003294 CA Practitioner - Pediatric Medicine 5294801635 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18892DCMDNeurology with Special Qualifications in Child Neurology Physician
C150674CAMDNeurodevelopmental Disabilities Physician
14663NHMDNeurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Uci Dept of Pediatrics CurrentSince Jul 31, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

19200 Jamboree Rd
Ste 1100
Irvine, CA 92612

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

2500 Red Hill Ave
Ste 100
Santa Ana, CA 92705
Phone (949) 267-0400

Organizations & group practices 2

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1295723450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 REDHILL AVE STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055518",
            "telephone_number": "949-267-0400",
            "fax_number": "949-221-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 REDHILL AVE STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055518",
            "telephone_number": "949-267-0400",
            "fax_number": "949-221-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTT",
        "first_name": "STEPHEN",
        "middle_name": "HAMILTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "DC",
            "license": "18892",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NH",
            "license": "14663",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NH",
            "license": "14663",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "DC",
            "license": "18892",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "CA",
            "license": "C150674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295723450",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016783",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30209003",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.