Individual provider Active NPI

Michael Chan-Wei Kao

  • Otolaryngology Physician
  • Fullerton, CA
National Provider Identifier
1639445554
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A161998 Issued in CA
Practice address
2240 N Harbor Blvd Ste 200
Fullerton, CA 92835-2635
Phone
(714) 447-4100
NPI assigned
Mar 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X A161998 CA Primary

Addresses

Primary practice location

2240 N Harbor Blvd Ste 200
Fullerton, CA 92835-2635

Mailing address

1950 Sunny Crest Dr Ste 3800
Fullerton, CA 92835-3647
Phone (714) 447-4100

Other practice location 1

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 447-4100

Other practice location 2

1950 Sunny Crest Dr Ste 3800
Fullerton, CA 92835
Phone (714) 447-4100

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191010002321 CA Practitioner - Otolaryngology 6204144652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
New York Medical College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2240 N Harbor Blvd
Suite 200
Fullerton, CA 92835-2635
Phone 7144474100224

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Merit-based Incentive Payment System (MIPS)

Final score
93.7 of 100Reported as group
Quality
100
Promoting interoperability
79
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A161998CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Orange County Ear Nose Throat Head & Neck Surgeons Inc Otolaryngology CurrentSince Oct 1, 2019 Accepting new patients
University of California Irvine Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

2240 N Harbor Blvd
Ste 200
Fullerton, CA 92835
Phone (714) 447-4100

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

1950 Sunny Crest Dr
Ste 3800
Fullerton, CA 92835
Phone (714) 447-4100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mkao1373718@oc.providencedirect.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1639445554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 3800",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353647",
            "telephone_number": "714-447-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 N HARBOR BLVD STE 200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352635",
            "telephone_number": "714-447-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Valencia Mesa Dr",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353809",
            "country_code": "US",
            "telephone_number": "714-447-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 Sunny Crest Dr Ste 3800",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "92835",
            "country_code": "US",
            "telephone_number": "714-447-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAO",
        "first_name": "MICHAEL",
        "middle_name": "CHAN-WEI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-25",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A161998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.