Individual provider Active NPI

Jeffrey G. Dyo, M.D.

  • Internal Medicine Physician
  • Costa Mesa, CA
National Provider Identifier
1538663158
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A163731 Issued in CA
Practice address
1640 Newport Blvd Ste 300
Costa Mesa, CA 92627-7725
Phone
(949) 386-5101
NPI assigned
Mar 20, 2018
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A163731 CA Primary

Addresses

Primary practice location

1640 Newport Blvd Ste 300
Costa Mesa, CA 92627-7725

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986

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
I20210712003899 CA Practitioner - Internal Medicine 8628489382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 5597663641, 61 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7002

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A163731CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
UC Regents CurrentSince Sep 1, 2021 Accepting new patients
Regents of the University of California Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients
UC Regents Current Accepting new patients
University of California Irvine Past Accepting new patients
Uci Medical Group Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

1640 Newport Blvd
Ste 100
Costa Mesa, CA 92627
Phone (949) 478-8000

1640 Newport Blvd
Ste 300
Costa Mesa, CA 92627
Phone (949) 386-5101

1640 Newport Blvd
Ste 350
Costa Mesa, CA 92627
Phone (949) 276-4008

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1538663158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD STE 300",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277725",
            "telephone_number": "949-386-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYO",
        "first_name": "JEFFREY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A163731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.