Individual provider Active NPI

Paolo Gabriel Jorge, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Fullerton, CA
National Provider Identifier
1669891727
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A144454 Issued in CA
Practice address
100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone
(714) 446-5200
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 55259 AZ
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A144454 CA Primary

Addresses

Primary practice location

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800

Mailing address

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone (714) 446-5200

Other practice location 1

11234 Anderson St
Loma Linda, CA 92354
Phone (909) 558-6202

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pjorge1374189@oc.providencedirect.org

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
I20190627001187 CA Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 2961758032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians
Sharwin Tafazoli IncGroup PAC ID 8729416953, 59 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2212 E 4TH St
Santa Ana, CA 92705-3870
Phone (714) 633-1011

3828 Delmas Ter
Culver City, CA 90232-2713
Phone (310) 836-7000

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A144454CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Nov 23, 2020 Accepting new patients
Pinnacle Pain & Regenerative Medicine Inc Pain Medicine CurrentSince Mar 10, 2020 Accepting new patients
Sharwin Tafazoli Inc CurrentSince Feb 1, 2024 Accepting new patients
Providence Medical Foundation CurrentSince Nov 23, 2020 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

3828 Delmas Ter
Culver City, CA 90232
Phone (310) 202-4745

100 E Valencia Mesa Dr
Ste 310
Fullerton, CA 92835
Phone (714) 446-5200

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

24452 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 630-0584

26732 Crown Valley Pkwy
Ste 541
Mission Viejo, CA 92691
Phone (949) 388-7190

4343 N Sierra Way
Sn Bernrdno, CA 92407
Phone (909) 886-4731

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pjorge1374189@oc.providencedirect.org

Organizations & group practices 6

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1669891727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR STE 310",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353800",
            "telephone_number": "714-446-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR STE 310",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353800",
            "telephone_number": "714-446-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "92354",
            "country_code": "US",
            "telephone_number": "909-558-6202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORGE",
        "first_name": "PAOLO",
        "middle_name": "GABRIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AZ",
            "license": "55259",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A144454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjorge1374189@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "100 E Valencia Mesa Dr Ste 310",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.