Individual provider Active NPI

Ali Sepehr, M.D.

  • Facial Plastic Surgery Physician
  • Newport Beach, CA
National Provider Identifier
1386833069
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
A93414 Issued in CA
Practice address
360 San Miguel Dr Ste 409
Newport Beach, CA 92660-7822
Phone
(949) 371-6963
Fax
(949) 313-7757
NPI assigned
Oct 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A93414 CA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X A93414 CA
Plastic Surgery Physician 208200000X A93414 CA
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X A93414 CA
Facial Plastic Surgery Physician 207YS0123X A93414 CA Primary

Addresses

Primary practice location

360 San Miguel Dr Ste 409
Newport Beach, CA 92660-7822

Mailing address

360 San Miguel Dr Ste 409
Newport Beach, CA 92660-7822
Phone (949) 371-6963

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
I20110125000957 CA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 4183803935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

360 San Miguel Dr
Suite 409
Newport Beach, CA 92660-7822
Phone (949) 371-6963

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93414CAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sepehr MD Apc Otolaryngology CurrentSince Apr 2, 2010 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Locations

16300 Sand Canyon Ave
Ste 201
Irvine, CA 92618
Phone (949) 727-1818

360 San Miguel Dr
Ste 409
Newport Beach, CA 92660
Phone (833) 880-7433

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": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1386833069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR STE 409",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607822",
            "telephone_number": "949-371-6963",
            "fax_number": "949-313-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR STE 409",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607822",
            "telephone_number": "949-371-6963",
            "fax_number": "949-313-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPEHR",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-18",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A93414",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "A93414",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A93414",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "CA",
            "license": "A93414",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A93414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.