Individual provider Active NPI

Joshua Icasas

  • Physician Assistant
  • Laguna Woods, CA
National Provider Identifier
1609429539
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60724 Issued in CA
Practice address
24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116
Phone
(949) 586-3200
NPI assigned
Jul 19, 2019
Last updated
Apr 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60724 CA Primary

Addresses

Primary practice location

24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116

Mailing address

24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220329001925 CA Practitioner - Physician Assistant 7315333424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OrthowestGroup PAC ID 3072932623, 48 clinicians

Practice addresses (Care Compare)

22 Odyssey
Suite 205
Irvine, CA 92618-3197
Phone (949) 586-3200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
60724CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthowest CurrentSince Mar 28, 2022 Accepting new patients
Orthowest Physician Assistant CurrentSince Mar 28, 2022 Accepting new patients
Orthowest Past Accepting new patients

Locations

18785 Brookhurst St
Ste 100
Fountain Valley, CA 92708
Phone (714) 500-5056

22 Odyssey
Ste 205
Irvine, CA 92618
Phone (949) 870-3332

24331 El Toro Rd
Ste 200
Laguna Woods, CA 92637
Phone (949) 767-0800

Interoperability endpoints

  • Direct secure messaging: jicasas737898@direct.memorialcare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1609429539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24331 EL TORO RD STE 200",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24331 EL TORO RD STE 200",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373116",
            "telephone_number": "949-586-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICASAS",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Woods, CA

Sources for this page

Verify at the official NPI Registry.