Individual provider Active NPI

Adnan Ismail, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Orange, CA
National Provider Identifier
1659765121
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
A155415 Issued in CA
Practice address
1201 W la Veta Ave
Orange, CA 92868-4203
Phone
(714) 509-4373
Fax
(714) 509-7800
NPI assigned
Mar 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A155415 CA
Student in an Organized Health Care Education/Training Program 390200000X NJ
Neonatal-Perinatal Medicine Physician 2080N0001X A155415 CA Primary

Addresses

Primary practice location

1201 W la Veta Ave
Orange, CA 92868-4203

Mailing address

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 509-4373

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
I20210510002161 CA Practitioner - Pediatric Medicine 0345659033 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155415CAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Uci Dept of Pediatrics Pediatrics CurrentSince Jul 1, 2021 Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
Pediatric Subspecialty Faculty, Inc. Pediatrics Past Accepting new patients

Locations

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

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.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1659765121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4373",
            "fax_number": "714-509-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4373",
            "fax_number": "714-509-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "ADNAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A155415",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A155415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.