Organization Active NPI

Nephrology Specialists Medical Group, Inc.

  • Specialist
  • Orange, CA
National Provider Identifier
1568424679
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEPHROLOGY SPECIALISTS MEDICAL GROUP, INC.
Practice address
705 W la Veta Ave Ste 107
Orange, CA 92868
Phone
(714) 639-4901
Fax
(714) 771-5389
NPI assigned
Apr 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Amer Jabara, M.D.NPI 1760475701
Title
President
Phone
(714) 639-4901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

705 W la Veta Ave Ste 107
Orange, CA 92868

Mailing address

705 W la Veta Ave Ste 107
Orange, CA 92868-4447
Phone (714) 693-7901

Other practice location 1

361 Hospital Rd Ste 227
Newport Beach, CA 92663-3523
Phone (949) 631-9215

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ73100ZMedicaidCA
ZZZ81344ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080319000358 CA Part B Supplier - Clinic/Group Practice 4981780798 Receives reassigned benefits from 7 practitioners
Practice locations: Newport Beach, CA; Orange, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0579139Nephrology Specialists Group Inc705 West la Veta Ave, Ste 107, Orange, CA 92868Provider-performed microscopyAug 31, 2026
05D0861129Nephrology Specialists Medical Group Inc361 Hospital Rd Ste 227, Newport Beach, CA 92663Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

307 Placentia Ave
Ste 103
Newport Beach, CA 92663
Phone (949) 631-9215

520 Superior Ave
Ste 340
Newport Beach, CA 92663
Phone (714) 963-7240

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7431/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1568424679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W LA VETA AVE STE 107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684447",
            "telephone_number": "714-693-7901",
            "fax_number": "714-771-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W LA VETA AVE STE 107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-639-4901",
            "fax_number": "714-771-5389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "361 Hospital Rd Ste 227",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926633523",
            "country_code": "US",
            "telephone_number": "949-631-9215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEPHROLOGY SPECIALISTS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "JABARA",
        "authorized_official_first_name": "AMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-639-4901",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ73100Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ81344Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.