Individual provider Active NPI

Michael E Van Ness, M.D.

  • Hematology (Pathology) Physician
  • San Juan Capistrano, CA
National Provider Identifier
1336450113
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Pathology) PhysicianTaxonomy code 207ZH0000X
License
A120590 Issued in CA
Practice address
33608 Ortega Hwy
San Juan Capistrano, CA 92675-2042
Phone
(949) 728-4579
NPI assigned
Jun 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Molecular Genetic Pathology (Pathology) Physician 207ZP0007X A120590 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A120590 CA
Hematology (Pathology) Physician 207ZH0000X A120590 CA Primary

Addresses

Primary practice location

33608 Ortega Hwy
San Juan Capistrano, CA 92675-2042

Mailing address

33608 Ortega Hwy
San Juan Capistrano, CA 92675-2042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A120590CAMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1336450113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33608 ORTEGA HWY",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33608 ORTEGA HWY",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752042",
            "telephone_number": "949-728-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NESS",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "CA",
            "license": "A120590",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A120590",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "CA",
            "license": "A120590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.