Charles William Gustav Eifrig, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

C53104 Issued in CA

Practice address

23521 Paseo de Valencia
Suite 207 (Taj Majal Building)
Laguna Hills, CA 92653-3107

Phone

(949) 707-5125

NPI assigned

Feb 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 17

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

Specialty

Ophthalmology

Education

University of North Carolina at Chapel Hill School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Associates of Orange CountyGroup PAC ID 8729159629, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ceifrig@retinaoc.intellechartdirect.net
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Retina Associates of Orange County

  • Ophthalmology Physician
  • Santa Ana, CA
  • NPI 1114105384
  Medicare reassignment Care Compare group NPD
• Desmond E. McGuire, M. D., Inc.

  • Ophthalmology Physician
  • Santa Ana, CA
  • NPI 1629187372
  NPD (past)
• Emergency Retina Surgical Services

  • Intermediate Emergency Medical Technician
  • Santa Ana, CA
  • NPI 1205155652
  NPD (past)
• John C Hwang MD Mba Inc

  • Ophthalmology Physician
  • Laguna Hills, CA
  • NPI 1841675816
  NPD (past)
• Los Alamitos Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Los Alamitos, CA
  • NPI 1497780084
  NPD (past)
• Orange County Global Medical Center, Inc

  • General Acute Care Hospital
  • Santa Ana, CA
  • NPI 1982697678
  NPD (past)
• Saddleback Memorial Medical Center

  • Rehabilitation Hospital Unit
  • Laguna Hills, CA
  • NPI 1114967114
  NPD (past)
• St Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  NPD (past)
• Retina Associates, PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Raleigh, NC
  • NPI 1760408397
  NPD (past)
• Rex Hospital, Inc.

  • Skilled Nursing Facility
  • Raleigh, NC
  • NPI 1376542878

  Ophthalmology

  NPD (past)
• St. Joseph Hospital

  • Specialist
  • Bethpage, NY
  • NPI 1881799153
  NPD (past)
• University of North Carolina

  • General Acute Care Hospital
  • Chapel Hill, NC
  • NPI 1790881118
  NPD (past)

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1306812979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA",
            "address_2": "SUITE 207 (TAJ MAJAL BUILDING)",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533107",
            "telephone_number": "949-707-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA",
            "address_2": "SUITE 207 (TAJ MAJAL BUILDING)",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533107",
            "telephone_number": "949-707-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIFRIG",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM GUSTAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200300335",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C53104",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "C53104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DB4007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL ID",
            "identifier": "P00102182",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE GROUP ID",
            "identifier": "562043271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL ID",
            "identifier": "134EF",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE INDIVID",
            "identifier": "2090301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI GROUP ID",
            "identifier": "562043271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE GROUP",
            "identifier": "562043271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST INDIVIDUAL ID",
            "identifier": "C7150",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE INDIVIDUAL ID",
            "identifier": "26600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST GROUP ID",
            "identifier": "562043271",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134EF",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI INDIVIDUAL ID",
            "identifier": "2115757",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO INDIVIDUAL ID",
            "identifier": "3201207",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO INDIVIDUAL ID",
            "identifier": "7674444",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "014T8",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014T8",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO/PPO GROUP ID",
            "identifier": "562043271",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Retina Specialist (Ophthalmology) Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.