NPIMap

Individual provider Active NPI

Jason Pang, M.D.

  • Nephrology Physician
  • Laguna Hills, CA
National Provider Identifier
1679644181
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A69884 Issued in CA
Practice address
24712 Clarington Dr
Laguna Hills, CA 92653-4305
Phone
(949) 770-1122
Fax
(949) 770-9189
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A69884 CA Primary
Specialist 174400000X A69884 CA

Addresses

Primary practice location

24712 Clarington Dr
Laguna Hills, CA 92653-4305

Mailing address

PO Box 8047
La Crescenta, CA 91224-0047
Phone (949) 770-1122

Other identifiers 1

IdentifierTypeStateIssuer
00A698840MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050207000174 CA Practitioner - NephrologyPractitioner - Internal Medicine 4486568110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of California, Irvine, California College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11039 Acacia Pkwy
Garden Grove, CA 92840-5126
Phone (714) 534-3366

30230 Rancho Viejo Rd
Suite 200
San Juan Capistrano, CA 92675-1585
Phone (714) 534-3366

Hospital & facility affiliations

  • DaVita San Juan Capistrano South Dialysis Dialysis facility, San Juan Capistrano, CA, CCN 052648
  • DaVita Costa Mesa Dialysis Dialysis facility, Costa Mesa, CA, CCN 552518
  • DaVita Saddleback Dialysis Dialysis facility, Laguna Hills, CA, CCN 052808
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A69884CAMDSpecialist

Practice roles (7 of 8)

OrganizationSpecialtyStatusNew patients
Jason J Pang MD Inc Nephrology CurrentSince Aug 21, 2007 Accepting new patients
Children'S Hospital at Mission Past Accepting new patients
Brent E Silvers MD Inc PastSince Oct 5, 2010 Accepting new patients
Advanced Hospitalist Medical Group, Inc. Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Kantor Nephrology Consultants, LTD Nephrology PastSince Dec 6, 2012 Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients

Locations

11039 Acacia Pkwy
Garden Grove, CA 92840
Phone (714) 534-3366

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

30230 Rancho Viejo Rd
Ste 200
San Juan Capo, CA 92675
Phone (949) 443-4114

200 Hospital Cir
Westminster, CA 92683
Phone (714) 386-9043

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jason.pang.p7@direct.monarchhealthcare.nextgenshare.com

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 8

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1679644181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8047",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912240047",
            "telephone_number": "949-770-1122",
            "fax_number": "949-770-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24712 CLARINGTON DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534305",
            "telephone_number": "949-770-1122",
            "fax_number": "949-770-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A69884",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A69884",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A698840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.