Individual provider Active NPI

John Ravera, MD

  • Urology Physician
  • Irvine, CA
National Provider Identifier
1558347674
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A333549 Issued in CA
Practice address
16100 Sand Canyon Ave
Ste 240
Irvine, CA 92618-3724
Phone
(949) 640-2081
Fax
(949) 640-1909
NPI assigned
Dec 20, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A333549 CA Primary
Urology Physician 208800000X C28250 CA

Addresses

Primary practice location

16100 Sand Canyon Ave
Ste 240
Irvine, CA 92618-3724

Mailing address

16100 Sand Canyon Ave
Ste 240
Irvine, CA 92618-3724
Phone (949) 640-2081

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
I20121115000247 CA Practitioner - Osteopathic Manipulative Medicine 2668623893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Saint Louis University School of Medicine, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16100 Sand Canyon Ave
Irvine, CA 92618-3716

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A333549CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth M Tokita MD Inc CurrentSince Jan 1, 2020 Accepting new patients
Urological Medical Group of North Orange County Urology PastSince Jun 28, 2017 Accepting new patients

Locations

16100 Sand Canyon Ave
Ste 130
Irvine, CA 92618
Phone (949) 417-1100

Organizations & group practices 2

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558347674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE",
            "address_2": "STE 240",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183724",
            "telephone_number": "949-640-2081",
            "fax_number": "949-640-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE",
            "address_2": "STE 240",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183724",
            "telephone_number": "949-640-2081",
            "fax_number": "949-640-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVERA",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2026-07-13",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A333549",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C28250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.