Senior Doc Kentucky PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SENIOR DOC KENTUCKY PSC

Practice address

5 Hutton Centre Dr Ste 950
Santa Ana, CA 92707-8744

Phone

(855) 434-7763

Fax

(949) 281-5550

NPI assigned

Sep 8, 2025

Organization subpart

No

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

Authorized official

Name

John Geiss, DONPI 1053651497

Title

Ceo

Phone

(657) 315-0858

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Mark Geiss, D.O.

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1053651497

  KY

  Medicare reassignment NPD Authorized official
• Jeffrey Thomas

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1932337136

  KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1548140684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HUTTON CENTRE DR STE 950",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927078744",
            "telephone_number": "855-434-7763",
            "fax_number": "949-281-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HUTTON CENTRE DR STE 950",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927078744",
            "telephone_number": "855-434-7763",
            "fax_number": "949-281-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR DOC KENTUCKY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-07",
        "status": "A",
        "authorized_official_last_name": "GEISS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "657-315-0858",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.