Kelly Elizabeth Fordyce, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A73294 Issued in CA

Practice address

26800 Crown Valley Pkwy
Suite 305
Mission Viejo, CA 92691-6384

Phone

(949) 364-6000

Fax

(949) 364-3213

NPI assigned

Jan 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Elizabeth Williams Former name

Electronic endpoints 1

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

Specialty

Internal Medicine

Education

University of California, Irvine, California College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kelly E Fordyce MD a Medical CorporationGroup PAC ID 9638579360, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
• Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.fordyce.1@23619.direct.athenahealth.com

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.

• Kelly E Fordyce MD a Medical Corporation

  • Internal Medicine Physician
  • Ladera Ranch, CA
  • NPI 1831772417
  Medicare reassignment Care Compare group NPD Authorized official
• Goleta Valley Cottage Hospital

  • Skilled Nursing Facility
  • Goleta, CA
  • NPI 1679587224
  NPD (past)
• Mission Hospital Regional Medical Center

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Santa Barbara Cottage Hospital

  • General Acute Care Hospital
  • Santa Barbara, CA
  • NPI 1477554152
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation
• Saddleback Memorial Medical Center

  • General Acute Care Hospital
  • Laguna Hills, CA
  • NPI 1275576381
  Care Compare affiliation

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1477531481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA",
            "address_2": "SUITE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330",
            "telephone_number": "949-282-1671",
            "fax_number": "949-367-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 305",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-364-6000",
            "fax_number": "949-364-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDYCE",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A73294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfordyce1373945@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "777 Corporate Dr Ste 140",
            "city": "Ladera Ranch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926942136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WILLIAMS",
            "middle_name": "ELIZABETH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Internal Medicine Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.