Individual provider Active NPI

Charles L Stewart, PA

  • Surgical Physician Assistant
  • Mission Viejo, CA
National Provider Identifier
1477511095
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA13562 Issued in CA
Practice address
26401 Crown Valley Pkwy
Suite 101
Mission Viejo, CA 92691-6302
Phone
(949) 348-4000
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA13562 CA Primary

Addresses

Primary practice location

26401 Crown Valley Pkwy
Suite 101
Mission Viejo, CA 92691-6302

Mailing address

26401 Crown Valley Pkwy
Suite 101
Mission Viejo, CA 92691-6302
Phone (949) 348-4000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111227000466 CA Practitioner - Physician Assistant 8123294055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Orthopedic Medical GroupGroup PAC ID 2365426517, 17 clinicians

Practice addresses (Care Compare)

26401 Crown Valley Pkwy
Suite 101
Mission Viejo, CA 92691-6302
Phone (949) 348-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13562CAMDAcupuncturist
PA13562CAMDSurgical Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477511095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916302",
            "telephone_number": "949-348-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916302",
            "telephone_number": "949-348-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA13562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.