Individual provider Active NPI

James Kenneth Dellorusso, M.D.

  • Anesthesiology Physician
  • Long Beach, CA
National Provider Identifier
1366425811
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A45146 Issued in CA
Practice address
1720 Termino Ave
Long Beach, CA 90804-2104
Phone
(562) 498-1000
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A45146 CA Primary

Addresses

Primary practice location

1720 Termino Ave
Long Beach, CA 90804-2104

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (800) 883-7243

Other identifiers 1

IdentifierTypeStateIssuer
00A451460MedicaidCA

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
I20040316001206 CA Practitioner - Anesthesiology 5294625281 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45146CAMDGeneral Practice Dentistry
A45146CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Anesthesia Inc a Medical Group Anesthesiology CurrentSince Sep 6, 2014 Accepting new patients
California Anesthesia Associates Medical Group, Inc. Anesthesiology Past Accepting new patients

Locations

5 Holland
Ste 101
Irvine, CA 92618
Phone (949) 588-2199

Organizations & group practices 2

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1366425811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 TERMINO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042104",
            "telephone_number": "562-498-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLORUSSO",
        "first_name": "JAMES",
        "middle_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A45146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A451460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.