Tustin Irvine Internal Medicine Group Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TUSTIN IRVINE INTERNAL MEDICINE GROUP INC.

Practice address

17400 Irvine Blvd
Suite F
Tustin, CA 92780-3030

Phone

(714) 838-5610

Fax

(714) 838-5931

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mario S Ficarola, M.D.NPI 1104939529

Title

President

Phone

(714) 838-5610

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: susanban@tustinirvi.allscriptsdirect.net
• Direct secure messaging: huongduong@tustinirvi.allscriptsdirect.net
• Direct secure messaging: neilpatel@tustinirvi.allscriptsdirect.net
• Direct secure messaging: thomashwang@tustinirvi.allscriptsdirect.net
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/71155
• Direct secure messaging: juliamotherway@tustinirvi.allscriptsdirect.net

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Huong T Duong, M.D.

  • Internal Medicine Physician
  • Tustin, CA
  • NPI 1013020437
  Medicare reassignment Care Compare group NPD
• Neil Patel, MD

  • Student in an Organized Health Care Education/Training Program
  • Orange, CA
  • NPI 1235767716
  Medicare reassignment Care Compare group NPD
• Susan L Ban, M.D.

  • Internal Medicine Physician
  • Tustin, CA
  • NPI 1053324970
  Medicare reassignment Care Compare group
• Mario S Ficarola, M.D.

  • Internal Medicine Physician
  • Corona, CA
  • NPI 1104939529
  Medicare reassignment Authorized official
• Thomas C Hwang, M.D.

  • Internal Medicine Physician
  • Tustin, CA
  • NPI 1124039722
  Medicare reassignment Care Compare group
• Julia Collins Motherway, M.D.

  • Internal Medicine Physician
  • Tustin, CA
  • NPI 1962544494
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1689633125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD",
            "address_2": "SUITE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-838-5610",
            "fax_number": "714-838-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD",
            "address_2": "SUITE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-838-5610",
            "fax_number": "714-838-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSTIN IRVINE INTERNAL MEDICINE GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "FICAROLA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-838-5610",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "YYY 42455 Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962544494",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY 42455 Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tustin Hospital and Medical Center
• Tustin Hospital and Medical Center
• Tustin Hospital and Medical Center
• Tustin Hospital and Medical Center
• Tustin Hospital and Medical Center
• Tustin Longevity Center
• Tustin Longevity Center
• Tustin Pharmacy, Inc.
• Tustin Physical Therapy Specialists, Inc.
• Tustin Place Medical Group

• Internal Medicine Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.