Individual provider Active NPI

Jacob P Kunes, DO

  • Internal Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1326381195
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A14662 Issued in CA
Practice address
1 Hoag Dr
Newport Beach, CA 92663-4162
Phone
(630) 824-7801
Fax
(714) 919-0163
NPI assigned
Mar 31, 2013
Last updated
Aug 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 20A14662 CA Primary

Addresses

Primary practice location

1 Hoag Dr
Newport Beach, CA 92663-4162

Mailing address

375 Redondo Ave
Ste 570
Long Beach, CA 90814-8130
Phone (630) 824-7801

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
I20180713002545 CA Practitioner - Internal Medicine 5496002982

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14662CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vincent Dat Nguyen Inc. Single Specialty Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1364688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1326381195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 REDONDO AVE",
            "address_2": "STE 570",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908148130",
            "telephone_number": "630-824-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "630-824-7801",
            "fax_number": "714-919-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNES",
        "first_name": "JACOB",
        "middle_name": "P",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-31",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A14662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.