NPIMap

Individual provider Active NPI

Matthew Kornswiet

  • Pediatrics Physician
  • Laguna Hills, CA
National Provider Identifier
1336534338
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A17197 Issued in CA
Practice address
23521 Paseo de Valencia Ste 200
Laguna Hills, CA 92653-3101
Phone
(949) 951-5437
NPI assigned
Apr 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 20A17197 CA
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 20A17197 CA Primary

Addresses

Primary practice location

23521 Paseo de Valencia Ste 200
Laguna Hills, CA 92653-3101

Mailing address

23521 Paseo de Valencia Ste 200
Laguna Hills, CA 92653-3101
Phone (949) 951-5437

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
20A17197CAMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Subspecialty Faculty, Inc. Single Specialty Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Hoag Memorial Hospital Presbyterian Single Specialty Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
Sea View Pediatric Medical Assoc. Inc. Single Specialty Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1336534338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA STE 200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533101",
            "telephone_number": "949-951-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA STE 200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533101",
            "telephone_number": "949-951-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNSWIET",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "CA",
            "license": "20A17197",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A17197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.