Organization Active NPI

Radin Cardiovascular Medical Group Inc

  • Cardiovascular Disease Physician
  • Newport Beach, CA
National Provider Identifier
1598021248
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G56739 Issued in CA
Legal business name
RADIN CARDIOVASCULAR MEDICAL GROUP INC
Practice address
1501 Superior Ave
#312
Newport Beach, CA 92663-3600
Phone
(949) 722-7555
Fax
(949) 515-3937
NPI assigned
Apr 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Michael M Radin, M.D.NPI 1407812449
Title
Owner
Phone
(949) 722-7555

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X G56739 CA Primary

Addresses

Primary practice location

1501 Superior Ave
#312
Newport Beach, CA 92663-3600

Mailing address

1501 Superior Ave
#312
Newport Beach, CA 92663-3600
Phone (949) 722-7555

Other identifiers 2

IdentifierTypeStateIssuer
GC590AOtherCAMEDICARE P-TAN
G56739OtherCAMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120529000090 CA Part B Supplier - Clinic/Group Practice 1355504556 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, 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
05D2058353Radin Cardiovascular Medical Group Inc1501 Superior Ave Suite 312, Newport Beach, CA 92663Certificate of waiverMay 5, 2027

National Provider Directory

National Provider Directory

Locations

1501 Superior Ave
Ste 312
Newport Beach, CA 92663
Phone (949) 722-7555

Practitioners & affiliated clinicians

Practitioners 1

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": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1598021248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE",
            "address_2": "#312",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633600",
            "telephone_number": "949-722-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE",
            "address_2": "#312",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633600",
            "telephone_number": "949-722-7555",
            "fax_number": "949-515-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIN CARDIOVASCULAR MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "RADIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-722-7555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G56739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-TAN",
            "identifier": "GC590A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G56739",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.