NPIMap

Organization Active NPI

Head and Neck Associates of Orange County an Incorprate

  • Specialist
  • Mission Viejo, CA
National Provider Identifier
1427093046
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HEAD AND NECK ASSOCIATES OF ORANGE COUNTY AN INCORPRATE
Practice address
26726 Crown Valley Pkwy
#200
Mission Viejo, CA 92691-8003
Phone
(949) 364-4361
Fax
(949) 364-4495
NPI assigned
Jun 18, 2006
Reactivated
Feb 27, 2008
Last updated
Nov 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Authorized official

Name
John S Supance, M.D.NPI 1194751727
Title
President
Phone
(949) 364-4361

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

26726 Crown Valley Pkwy
#200
Mission Viejo, CA 92691-8003

Mailing address

26726 Crown Valley Kwy
#200
Mission Viejo, CA 92691-8003
Phone (949) 364-4361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050207000933 CA Part B Supplier - Clinic/Group Practice 0547211518 Receives reassigned benefits from 18 practitioners
Practice locations: Costa Mesa, CA; Irvine, CA; Laguna Hills, CA; Mission Viejo, CA; San Clemente, CA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

18 Endeavor
Ste 208
Irvine, CA 92618
Phone (949) 276-4008

24411 Health Center Dr
Ste 370
Laguna Hills, CA 92653
Phone (949) 276-4008

26726 Crown Valley Pkwy
Ste 200
Mission Viejo, CA 92691
Phone (949) 264-4361

675 Camino de los Mares
Ste 440
San Clemente, CA 92673

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1427093046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26726 CROWN VALLEY KWY",
            "address_2": "#200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918003",
            "telephone_number": "949-364-4361",
            "fax_number": "949-364-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26726 CROWN VALLEY PKWY",
            "address_2": "#200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918003",
            "telephone_number": "949-364-4361",
            "fax_number": "949-364-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAD AND NECK ASSOCIATES OF ORANGE COUNTY AN INCORPRATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2014-11-21",
        "deactivation_date": "2007-09-25",
        "reactivation_date": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "SUPANCE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-364-4361",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.