NPIMap

Individual provider Active NPI

Simon Joseph Madorsky, M.D.

  • Otolaryngology Physician
  • Newport Beach, CA
National Provider Identifier
1447259981
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A50075 Issued in CA
Practice address
180 Newport Center Dr
158
Newport Beach, CA 92660-6972
Phone
(949) 719-1800
Fax
(949) 719-1810
NPI assigned
Jul 18, 2005
Last updated
Oct 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A50075 CA Primary
Facial Plastic Surgery Physician 207YS0123X A50075 CA

Addresses

Primary practice location

180 Newport Center Dr
158
Newport Beach, CA 92660-6972

Mailing address

PO Box 6765
Orange, CA 92863-6765
Phone (714) 571-5000

Other identifiers 3

IdentifierTypeStateIssuer
P01404246OtherRAILROAD MEDICARE
00A500750MedicaidCA
P00002596OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071129000754 CA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 7618861477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Baylor College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Newport Beach Surgical and Medical Group IncGroup PAC ID 3577784750, 11 clinicians

Practice addresses (Care Compare)

17451 Bastanchury Rd
Suite 103a
Yorba Linda, CA 92886-1871
Phone (714) 961-0265

180 Newport Ctr Dr
Suite 158
Newport Beach, CA 92660-0934
Phone (949) 719-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.57 of 100Reported as group
Quality
77.27
Promoting interoperability
99
Improvement activities
40
Cost
38.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision197
Removal of tissue1-10
Removal of skin lesions84
Removal or shaving of skin growth1-10
Skin biopsy91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50075CAMDDentist
A50075CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Beach Surgical and Medical Group Inc Otolaryngology CurrentSince Dec 1, 2014 Accepting new patients
Oregon Adult Medicine PC Past Accepting new patients
Pacific Coast Cardiology Medical Group Past Accepting new patients
Reconstructive Surgery Center of Newport Beach Inc PastSince Sep 12, 2012 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Children's Hospital of Orange County Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Entrust Medical Corporation Otolaryngology Past Accepting new patients

Locations

180 Newport Center Dr
Ste 158
Newport Beach, CA 92660
Phone (949) 209-1622

17451 Bastanchury Rd
Ste 103A
Yorba Linda, CA 92886
Phone (714) 961-0143

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJFCD
  • Direct secure messaging: simon.madorsky.p1@direct.sms.nextgenshare.com

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, 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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1447259981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6765",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928636765",
            "telephone_number": "714-571-5000",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NEWPORT CENTER DR",
            "address_2": "158",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606972",
            "telephone_number": "949-719-1800",
            "fax_number": "949-719-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADORSKY",
        "first_name": "SIMON",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A50075",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A50075",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01404246",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A500750",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00002596",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.