Individual provider Active NPI

Patrick S Thompson, MD

  • Family Medicine Physician
  • Aliso Viejo, CA
National Provider Identifier
1417938630
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G45100 Issued in CA
Practice address
26538 Moulton Pkwy Ste 38E
Aliso Viejo, CA 92653
Phone
(949) 448-0656
NPI assigned
Nov 7, 2005
Last updated
Jul 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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 G45100 CA Primary

Addresses

Primary practice location

26538 Moulton Pkwy Ste 38E
Aliso Viejo, CA 92653

Mailing address

17360 Brookhurst St
Attn: MCMF - Credentialing Department
Fountain Valley, CA 92708-3720

Other identifiers 1

IdentifierTypeStateIssuer
00G451000MedicaidCA

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
I20091009000202 CA Practitioner - Family Practice 5092851741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

11420 Warner Ave
Fountain Valley, CA 92708-2529
Phone (714) 549-1300

23512 Madero
Mission Viejo, CA 92691-2743
Phone (949) 583-1600

24268 El Toro Rd
Laguna Woods, CA 92637-3435
Phone (657) 241-8455

29472 Avenida de Las Bandera
Rancho Santa Margarita, CA 92688-2651
Phone (949) 459-9968

30492 Gateway PL
Suite 110
Rancho Mission Viejo, CA 92694-1862
Phone (657) 241-8435

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45100CAMDMarriage & Family Therapist
G45100CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Feb 1, 2011 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

26538 Moulton Pkwy
Ste 38E
Laguna Hills, CA 92653
Phone (949) 448-0656

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

Interoperability endpoints

  • Direct secure messaging: pthompson193505@direct.memorialcare.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1417938630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "address_2": "ATTN: MCMF - CREDENTIALING DEPARTMENT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26538 MOULTON PKWY STE 38E",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-448-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "PATRICK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G45100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G451000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

Verify at the official NPI Registry.