Individual provider Active NPI

Mithya Jayakumar Morton

  • Student in an Organized Health Care Education/Training Program
  • Orange, CA
National Provider Identifier
1649929472
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
505 S Main St Ste 525
Orange, CA 92868-4553
Phone
(714) 456-5631
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 190814 CA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

505 S Main St Ste 525
Orange, CA 92868-4553

Mailing address

845 N Kathleen LN Apt a
Orange, CA 92867-7483
Phone (408) 223-5199

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
I20231218000952 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8729437652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
190814CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine PastSince Mar 27, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1649929472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N KATHLEEN LN APT A",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677483",
            "telephone_number": "408-223-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTON",
        "first_name": "MITHYA",
        "middle_name": "JAYAKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "190814",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.