Individual provider Active NPI

Edward George Rohaly, M.D,.

  • Dermatology Physician
  • Newport Beach, CA
National Provider Identifier
1669522819
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G62009 Issued in CA
Practice address
360 San Miguel Dr Ste 309
Newport Beach, CA 92660-7829
Phone
(949) 640-0434
Fax
(949) 640-0277
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G62009 CA Primary

Addresses

Primary practice location

360 San Miguel Dr Ste 309
Newport Beach, CA 92660-7829

Mailing address

360 San Miguel Dr Ste 309
Newport Beach, CA 92660-7829
Phone (949) 640-0434

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
I20101208000685 CA Practitioner - Dermatology 0840487419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Temple University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Csi Medical GroupGroup PAC ID 5890916845, 104 clinicians

Practice addresses (Care Compare)

360 San Miguel Dr
Suite 309
Newport Beach, CA 92660-7829
Phone (949) 640-0434

Merit-based Incentive Payment System (MIPS)

Final score
85.34 of 100Reported as group
Quality
90.85
Promoting interoperability
87
Improvement activities
40
Cost
71.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision176
Removal of tissue18
Removal of skin lesions2305
Removal of skin cancer477
Removal of nail tissue1-10
Removal or shaving of skin growth15
Skin biopsy861

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G62009CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Csi Medical Group Dermatology CurrentSince Jan 3, 2023 Accepting new patients
David B. Friedman, MD, Inc Dermatology Current Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Locations

1165 N Euclid St
Anaheim, CA 92801
Phone (714) 991-9990

11100 Warner Ave
Ste 264
Fountain Vly, CA 92708
Phone (714) 549-1770

360 San Miguel Dr
Ste 309
Newport Beach, CA 92660
Phone (949) 640-0434

1441 Avocado Ave
Ste 409
Newport Beach, CA 92660
Phone (949) 640-4501

4201 Torrance Blvd
Ste 640
Torrance, CA 90503
Phone (310) 375-9994

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: drrohaly@csisouthca.emadirect.md

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1669522819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR STE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607829",
            "telephone_number": "949-640-0434",
            "fax_number": "949-640-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR STE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607829",
            "telephone_number": "949-640-0434",
            "fax_number": "949-640-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHALY",
        "first_name": "EDWARD",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D,.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G62009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.