Individual provider Active NPI

Ying Peng, MD, PHD

  • Pediatric Neurodevelopmental Disabilities Physician
  • Ladera Ranch, CA
National Provider Identifier
1528156429
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
A72981 Issued in CA
Practice address
333 Corporate Dr
Ladera Ranch, CA 92694-2113
Phone
(949) 215-6662
Fax
(949) 215-6663
NPI assigned
Oct 10, 2006
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X A72981 CA Primary

Addresses

Primary practice location

333 Corporate Dr
Ladera Ranch, CA 92694-2113

Mailing address

333 Corporate Dr Ste 110
Ladera Ranch, CA 92694-2113
Phone (949) 215-6662

Other identifiers 1

IdentifierTypeStateIssuer
00A729810MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041118000751 CA Practitioner - NeurologyPractitioner - Pediatric MedicinePractitioner - Other (Physician) 5597729558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

333 Corporate Dr
Suite 110
Ladera Ranch, CA 92694-2113
Phone (949) 215-6662

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72981CAMDPediatric Neurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ying Peng MD, PH.D Inc. Neurodevelopmental Disabilities CurrentSince Dec 2, 2013 Accepting new patients
University of California Irvine Past Accepting new patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients
Children's Hospital of Orange County Past Accepting new patients

Locations

333 Corporate Dr
Ste 110
Ladera Ranch, CA 92694
Phone (949) 215-6662

26451 Crown Valley Pkwy
Ste 100
Mission Viejo, CA 92691
Phone (949) 367-1335

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1528156429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR STE 110",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942113",
            "telephone_number": "949-215-6662",
            "fax_number": "949-215-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942113",
            "telephone_number": "949-215-6662",
            "fax_number": "949-215-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "YING",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "CA",
            "license": "A72981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A729810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

Verify at the official NPI Registry.