NPIMap

Individual provider Active NPI

Raj Menon, M.D.

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1316014954
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A38792 Issued in CA
Practice address
3620 S Bristol St
Suite 102
Santa Ana, CA 92704-7300
Phone
(714) 556-6666
Fax
(714) 556-4548
NPI assigned
Nov 29, 2006
Last updated
Mar 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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 A38792 CA Primary

Addresses

Primary practice location

3620 S Bristol St
Suite 102
Santa Ana, CA 92704-7300

Mailing address

3620 S Bristol St
Suite 102
Santa Ana, CA 92704-7300
Phone (714) 556-6666

Other identifiers 2

IdentifierTypeStateIssuer
00A387920MedicaidCA
A85176OtherUPIN

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
I20080116000328 CA Practitioner - Family Practice 3173547395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3620 S Bristol St
Suite 102
Santa Ana, CA 92704-7314
Phone (714) 556-6666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38792CAMDDentist
A38792CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raj Menon, MD,Inc Family Medicine CurrentSince Dec 21, 2009 Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients
University of California Irvine Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Gardena Hospital LP Past Accepting new patients
Peacehealth Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

3620 S Bristol St
Ste 102
Santa Ana, CA 92704
Phone (714) 556-6666

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 14

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.

View all 14

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1316014954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 S BRISTOL ST",
            "address_2": "SUITE 102",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047300",
            "telephone_number": "714-556-6666",
            "fax_number": "714-556-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 S BRISTOL ST",
            "address_2": "SUITE 102",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047300",
            "telephone_number": "714-556-6666",
            "fax_number": "714-556-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A387920",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "A85176",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.