Organization Active NPI

Newport Pain Management Medical

  • Specialist
  • Newport Beach, CA
National Provider Identifier
1639242811
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G71041 Issued in CA
Legal business name
NEWPORT PAIN MANAGEMENT MEDICAL
Practice address
1401 Avocado Ave
101
Newport Beach, CA 92660-7720
Phone
(949) 759-8400
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Authorized official

Name
Herbert Rand Scott, M.D.NPI 1841363959
Title
President
Phone
(949) 759-8400

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 G71041 CA Primary

Addresses

Primary practice location

1401 Avocado Ave
101
Newport Beach, CA 92660-7720

Mailing address

1401 Avocado Ave
101
Newport Beach, CA 92660-7720
Phone (949) 759-8400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100803000570 CA Part B Supplier - Clinic/Group Practice 1951434521 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279843200000",
    "number": "1639242811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE",
            "address_2": "101",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607720",
            "telephone_number": "949-759-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE",
            "address_2": "101",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607720",
            "telephone_number": "949-759-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT PAIN MANAGEMENT MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2010-07-23",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "RAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-759-8400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G71041",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 23, 2010; 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.