Individual provider Active NPI

Ani Bergman Baghdassarian

  • Internal Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1679899033
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A121527 Issued in CA
Practice address
510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663
Phone
(949) 791-3001
Fax
(949) 791-3096
NPI assigned
Apr 10, 2010
Last updated
Feb 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A121527 CA Primary

Addresses

Primary practice location

510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663

Mailing address

510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663
Phone (949) 791-3001

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
I20130801000376 CA Practitioner - Internal Medicine 1456592526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
St. Louis College of Physicians and Surgeons, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

360 San Miguel Dr
Suite 105
Newport Beach, CA 92660-7815
Phone (949) 717-0072

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Mar 1, 2019 Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

360 San Miguel Dr
Ste 105
Newport Beach, CA 92660
Phone (949) 365-3534

510 Superior Ave
Ste 200B
Newport Beach, CA 92663
Phone (800) 400-4624

510 Superior Ave
Ste 290
Newport Beach, CA 92663
Phone (949) 764-4500

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1270857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1679899033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "address_2": "STE 200B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "949-791-3001",
            "fax_number": "949-791-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "address_2": "STE 200B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "949-791-3001",
            "fax_number": "949-791-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGHDASSARIAN",
        "first_name": "ANI",
        "middle_name": "BERGMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-10",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A121527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.