Adam Vojin Djurdjulov, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A118099 Issued in CA

Practice address

1 Hoag Dr
Newport Beach, CA 92663-4162

Phone

(949) 764-5438

Fax

(949) 764-5674

NPI assigned

Jun 16, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Newport Harbor Anesthesia Consultants Medical Group Inc

  • Anesthesiology Physician
  • Newport Beach, CA
  • NPI 1205885357
  Medicare reassignment NPD

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1639490402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900516712",
            "telephone_number": "626-795-6596",
            "fax_number": "626-795-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-5438",
            "fax_number": "949-764-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJURDJULOV",
        "first_name": "ADAM",
        "middle_name": "VOJIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "PIT # BP10038241",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A118099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Ditolla, D.D.S.
• Diversified Ambulatory Surgical Medical Center
• Rolane Tweenie T. Tacbas Diya, AU.D.
• Regina Bacani Dizon, PMHNP-BC
• Vania Djavid
• Duc H. DO, M.D.
• Linda DO, D.O.
• Kenneth Dobbs, D.C.
• William Dobkin, M.D.
• Roxanne Dockery

• Anesthesiology Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.