Individual provider Active NPI

Antigone Gonis, MD

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1366902199
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A177615 Issued in CA
Practice address
800 N Main St
Santa Ana, CA 92701-3576
Phone
(714) 880-7812
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A177615 CA Primary

Addresses

Primary practice location

800 N Main St
Santa Ana, CA 92701-3576

Mailing address

20151 SW Birch St Ste 100
Newport Beach, CA 92660-1794
Phone (949) 270-2100

Other practice location 1

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 880-7812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221109001772 CA Practitioner - Family Practice 1658748322 Reassigns benefits to 2 organizations
I20241205002133 NY Practitioner - Family Practice 1658748322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Share Our Selves CorporationGroup PAC ID 4789854993, 7 clinicians
University of California IrvineGroup PAC ID 5395658181, 57 clinicians

Practice addresses (Care Compare)

1014 N Broadway
Santa Ana, CA 92701-3408
Phone (949) 270-2160

1550 Superior Ave
Costa Mesa, CA 92627-3653
Phone (949) 270-2100

27725 Santa Margarita Pkwy
Suite 101
Mission Viejo, CA 92691-6706
Phone (949) 270-2100

800 N Main St
Santa Ana, CA 92701-3576
Phone (714) 456-6324

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177615CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine Current Accepting new patients
University of California Irvine CurrentSince Oct 1, 2025 Accepting new patients
Share Our Selves Corporation CurrentSince Jul 28, 2022 Accepting new patients
University of California Irvine CurrentSince Oct 1, 2025 Accepting new patients
Share Our Selves Corporation CurrentSince Jul 28, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Sep 27, 2024 Accepting new patients
Share Our Selves Corporation Current Accepting new patients
Montefiore Medical Center CurrentSince Sep 27, 2024 Accepting new patients
University of California Irvine Past Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

1550 Superior Ave
Costa Mesa, CA 92627
Phone (949) 650-0186

20151 SW Birch St
Ste 100
Newport Beach, CA 92660

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

1014 N Broadway
Santa Ana, CA 92701
Phone (949) 270-2132

111 E 210th St
Bronx, NY 10467

100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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 2

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1366902199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20151 SW BIRCH ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601794",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927013576",
            "telephone_number": "714-880-7812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 The City Dr S",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-880-7812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONIS",
        "first_name": "ANTIGONE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A177615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.