Individual provider Active NPI

William J Vandalsem, M.D.

  • Diagnostic Radiology Physician
  • Newport Beach, CA
National Provider Identifier
1316975816
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G62331 Issued in CA
Practice address
One Hoag Drive
Newport Beach, CA 92663-4162
Phone
(949) 764-5570
Fax
(949) 263-1639
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G62331 CA Primary

Addresses

Primary practice location

One Hoag Drive
Newport Beach, CA 92663-4162

Mailing address

Dept la 21555
Pasadena, CA 91185-1555
Phone (949) 764-5570

Other identifiers 2

IdentifierTypeStateIssuer
00G623310OtherCABLUE SHIELD
00G623310MedicaidCA

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
I20040130001111 CA Practitioner - Diagnostic Radiology 3678476173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Stanford University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport Harbor Radiology Associates Medical Group IncGroup PAC ID 1850285735, 69 clinicians
Newport Center Radiology Associates Medical Group IncGroup PAC ID 7810800166, 60 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 645-3534

15000 Kensington Park Dr
Suite 150
Tustin, CA 92782-1836
Phone (714) 477-8340

16200 Sand Canyon Ave
Irvine, CA 92618-3714
Phone (949) 764-4624

16250 Sand Canyon Ave
Irvine, CA 92618-3714
Phone (949) 365-3534

19582 Beach Blvd
Suite 160
Huntington Beach, CA 92648-2996
Phone (714) 378-4992

360 San Miguel Dr
Suite 105And106
Newport Beach, CA 92660-7853
Phone (949) 365-3534

3877 Portola Pkwy
Irvine, CA 92602-0828
Phone (949) 557-0720

6352 Irvine Blvd
Irvine, CA 92620-2102
Phone (949) 764-2888

993 Avenida Pico
Suite 110
San Clemente, CA 92673-3908
Phone (949) 764-5573

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.45 of 100Reported as group
Quality
100
Improvement activities
40
Cost
84.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62331CAMDPharmacist
G62331CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Harbor Radiology Associates Medical Group, Inc Diagnostic Radiology CurrentSince Mar 15, 1998 Accepting new patients
Newport Center Radiology Associates Medical Group Inc Diagnostic Radiology CurrentSince Mar 15, 1998 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Locations

18301 Von Karman Ave
Ste 310
Irvine, CA 92612
Phone (949) 645-3534

16200 Sand Canyon Ave
Irvine, CA 92618
Phone (949) 753-2000

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

360 San Miguel Dr
Ste 1
Newport Beach, CA 92660
Phone (949) 365-3534

455 Old Newport Blvd
Ste 101
Newport Beach, CA 92663
Phone (949) 574-8200

Dept LA 21705
Pasadena, CA 91185

Dept LA 21555
Pasadena, CA 91185
Phone (949) 236-8620

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1316975816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21555",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851555",
            "telephone_number": "949-764-5570",
            "fax_number": "949-263-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOAG DRIVE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-5570",
            "fax_number": "949-263-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDALSEM",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G62331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G623310",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G623310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.