Individual provider Active NPI

Heesook Choi, NP

  • Family Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1679068845
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005947 Issued in CA
Practice address
1150 Baker St
Costa Mesa, CA 92626-4111
Phone
(714) 662-7517
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005947 CA Primary

Addresses

Primary practice location

1150 Baker St
Costa Mesa, CA 92626-4111

Mailing address

1150 Baker St
Costa Mesa, CA 92626-4111
Phone (866) 389-2727

Other practice location 1

5630 E Santa Ana Canyon Rd
Anaheim, CA 92807-3122
Phone (714) 257-6170

Other practice location 2

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 628-3300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190717002405 CA Practitioner - Nurse Practitioner 6204161961 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

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

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

395 W Avenida Vista Hermosa
San Clemente, CA 92672-7720
Phone (949) 304-2117

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Sep 21, 2020 Accepting new patients
Providence Medical Foundation CurrentSince Sep 21, 2020 Accepting new patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Jun 7, 2019 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
Express Care Or PC PastSince Apr 19, 2020 Accepting new patients

Locations

5630 E Santa Ana Canyon Rd
Anaheim, CA 92807
Phone (714) 257-6170

1150 Baker St
Costa Mesa, CA 92626
Phone (714) 622-7517

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
#1051182
Fullerton, CA 92835
Phone (714) 446-5200

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

26800 Crown Valley Pkwy
Ste 150
Mission Viejo, CA 92691
Phone (949) 276-2111

2501 E Chapman Ave
Orange, CA 92869
Phone (714) 628-3300

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

395 W Avenida Vista Hermosa
Ste 395F
San Clemente, CA 92672

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3154

Interoperability endpoints

  • Direct secure messaging: hchoi1415670@oc.providencedirect.org

Organizations & group practices 7

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1679068845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 BAKER ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264111",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 BAKER ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264111",
            "telephone_number": "714-662-7517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5630 E Santa Ana Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928073122",
            "country_code": "US",
            "telephone_number": "714-257-6170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 E Chapman Ave",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928693204",
            "country_code": "US",
            "telephone_number": "714-628-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOI",
        "first_name": "HEESOOK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.