Individual provider Active NPI

Gary M. Levine, M.D.

  • Diagnostic Radiology Physician
  • Laguna Hills, CA
National Provider Identifier
1689614224
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G64219 Issued in CA
Practice address
24401 Calle de la Louisa Ste 200
Laguna Hills, CA 92653
Phone
(949) 452-7200
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G64219 CA Primary

Addresses

Primary practice location

24401 Calle de la Louisa Ste 200
Laguna Hills, CA 92653

Mailing address

PO Box 51787
Los Angeles, CA 90051-6087
Phone (949) 452-7200

Other identifiers 2

IdentifierTypeStateIssuer
00G642190OtherCABLUE SHIELD
00G642190MedicaidCA

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
I20041108001301 CA Practitioner - Diagnostic Radiology 7416856976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albany Medical College of Union University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breast Care Specialists Medical Group IncGroup PAC ID 8527380690, 5 clinicians

Practice addresses (Care Compare)

24401 Calle de la Louisa
Suite 200
Laguna Hills, CA 92653-3624
Phone (949) 452-7200

Hospital & facility affiliations

  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Merit-based Incentive Payment System (MIPS)

Final score
55 of 100Reported as group
Quality
10
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G64219CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breast Care Specialists Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 1, 2014 Accepting new patients
Newport Center Radiology Associates Medical Group Inc Diagnostic Radiology CurrentSince Nov 1, 2004 Accepting new patients
Santa Ana Tustin Radiology Medical Group Diagnostic Radiology Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients

Locations

6301 S McClintock Dr
Ste 215
Tempe, AZ 85283
Phone (480) 820-6657

15500 Sand Canyon Ave
Ste 120
Irvine, CA 92618
Phone (949) 462-3999

4040 Barranca Pkwy
Ste 110
Irvine, CA 92604
Phone (949) 857-0676

24401 Health Center Dr
Laguna Hills, CA 92653

2001 Westcliff Dr
Ste 103
Newport Beach, CA 92660
Phone (714) 378-7955

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

360 San Miguel Dr
Ste 1
Newport Beach, CA 92660
Phone (949) 365-3534

455 Old Newport Blvd
Ste 101
Newport Beach, CA 92663
Phone (949) 574-8200

Dept LA 21705
Pasadena, CA 91185

30492 Gateway Pl
Ste 100
Rancho Mission Viejo, CA 92694

1300 Avenida Vista Hermosa
Ste 180
San Clemente, CA 92673
Phone (949) 542-7700

Organizations & group practices 5

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 7

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1689614224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51787",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900516087",
            "telephone_number": "949-452-7200",
            "fax_number": "949-464-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24401 CALLE DE LA LOUISA STE 200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-452-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "GARY",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G64219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G642190",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G642190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.