Individual provider Active NPI

Charlie Huang, D.O.

  • Internal Medicine Physician
  • Tustin, CA
National Provider Identifier
1427591577
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A14941 Issued in CA
Practice address
15000 Kensington Park Dr Ste 250
Tustin, CA 92782
Phone
(714) 477-8320
NPI assigned
Nov 21, 2016
Last updated
Sep 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A14941 CA Primary

Addresses

Primary practice location

15000 Kensington Park Dr Ste 250
Tustin, CA 92782

Mailing address

15000 Kensington Park Dr Ste 250
Tustin, CA 92782-1835

Other practice location 1

47 Latitude
Irvine, CA 92618-8821
Phone (562) 305-4772

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
I20180918002414 CA Practitioner - Internal Medicine 3375894199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

16300 Sand Canyon Ave
Suite 311
Irvine, CA 92618-3703
Phone (949) 791-3101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14941CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Mar 1, 2019 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

16300 Sand Canyon Ave
Ste 311
Irvine, CA 92618
Phone (949) 753-7475

510 Superior Ave
Ste 290
Newport Beach, CA 92663
Phone (949) 764-4500

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

15000 Kensington Park Dr
Ste 250
Tustin, CA 92782
Phone (714) 477-8320

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 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": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1427591577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 KENSINGTON PARK DR STE 250",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 KENSINGTON PARK DR STE 250",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92782",
            "telephone_number": "714-477-8320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Latitude",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926188821",
            "country_code": "US",
            "telephone_number": "562-305-4772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUANG",
        "first_name": "CHARLIE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-21",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A14941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.