NPIMap

Organization Active NPI

Vituity - Urgent Care Services PC

  • Urgent Care Clinic/Center
  • Mission Viejo, CA
National Provider Identifier
1598394686
Registry record updated Jun 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
VITUITY - URGENT CARE SERVICES PC
Practice address
23962 Alicia Pkwy Ste I-1
Mission Viejo, CA 92691-3940
Phone
(949) 452-7699
Fax
(949) 770-2815
NPI assigned
Apr 2, 2020
Last updated
Jun 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2021

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

Authorized official

Name
Theophile G. Koury, MD
Title
President
Phone
(510) 350-2842

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Urgent Care Clinic/Center 261QU0200X NU Primary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

23962 Alicia Pkwy Ste I-1
Mission Viejo, CA 92691-3940

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 350-2842

Other names 1

  • Vituity Urgent Care Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200807000845 CA Part B Supplier - Clinic/Group Practice 8022433085 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cameron Park, CA
O20210818001053 WA Part B Supplier - Clinic/Group Practice 8022433085 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

22855 Lake Forest Dr
Ste A
Lake Forest, CA 92630
Phone (949) 452-7544

23962 Alicia Pkwy
Ste I1
Mission Viejo, CA 92691
Phone (949) 297-0238

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622937600000",
    "number": "1598394686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-350-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23962 ALICIA PKWY STE I-1",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913940",
            "telephone_number": "949-452-7699",
            "fax_number": "949-770-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITUITY - URGENT CARE SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-02",
        "last_updated": "2021-06-06",
        "certification_date": "2021-06-06",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-350-2842",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vituity Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2021; 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.