Active NPI
Victor Raphael Beretta, MD
- Anesthesiology Physician
- Newport Beach, CA
National Provider Identifier
1497795611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A42347
- Practice address
- One Hoag Drive
Department of Anesthesiology
Newport Beach, CA 92663-4162 - Phone
- (949) 764-6954
- Fax
- (949) 764-5674
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A42347 | CA | Primary |
Addresses
Primary practice location
One Hoag Drive
Department of Anesthesiology
Newport Beach, CA 92663-4162
Mailing address
One Hoag Drive
Department of Anesthesiology
Newport Beach, CA 92663-4162
Phone (949) 764-6954
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A423470 | Medicaid | CA | |
| 00A423470 | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A42347 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoag Memorial Hospital Presbyterian | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Newport Beach, CA
- NPI 1518951300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1497795611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE HOAG DRIVE",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926634162",
"telephone_number": "949-764-6954",
"fax_number": "949-764-5674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE HOAG DRIVE",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926634162",
"telephone_number": "949-764-6954",
"fax_number": "949-764-5674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERETTA",
"first_name": "VICTOR",
"middle_name": "RAPHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A42347",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A423470",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00A423470",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.