Mitchell Watanabe, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A44130 Issued in CA

Practice address

1212 W 17TH St
Santa Ana, CA 92706-3418

Phone

(714) 641-7100

Fax

(714) 434-4500

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Family Practice

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678
• Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Merit-based Incentive Payment System (MIPS)

Final score

87.17 of 100Reported as group

Quality

81.15

Promoting interoperability

100

Improvement activities

40

Cost

71.64

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mwatanabe81373@direct.memorialcare.org

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760
  NPD (past)
• Children'S Hospital at Mission

  • Children's Hospital
  • Mission Viejo, CA
  • NPI 1699868398
  NPD (past)
• Children'S Hospital of Orange County

  • Children's Hospital
  • Orange, CA
  • NPI 1811080526
  NPD (past)
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• Long Beach Memorial Medical

  • Children's Hospital
  • Long Beach, CA
  • NPI 1477596583
  NPD (past)
• Mission Hospital Regional Medical Center

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  NPD (past)
• Saddleback Memorial Medical Center

  • Rehabilitation Hospital Unit
  • Laguna Hills, CA
  • NPI 1114967114
  NPD (past)

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

• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1528049996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 DOW AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807242",
            "telephone_number": "714-665-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063418",
            "telephone_number": "714-641-7100",
            "fax_number": "714-434-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A44130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A441300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Washington
• Kiana Washington
• Sydney Denise Washington
• Innocent Wasike
• Denise J. Wasserman, MSW
• Kristine Waterlander, NP
• Sheran Elizabeth Waters-Lanchester, MA,. AMFT
• Christiane M Waters, N.P.
• Felicia Watkins
• Kimberly Watkins

• Family Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.