Individual provider Active NPI

Maryann Nuesse, D.O.

  • Adult Medicine Physician
  • Orange, CA
National Provider Identifier
1689633455
Registry record updated Jun 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
20A7305 Issued in CA
Practice address
867 S Tustin St
Orange, CA 92866-3426
Phone
(714) 771-1420
Fax
(714) 771-6918
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 20A7305 CA Primary

Addresses

Primary practice location

867 S Tustin St
Orange, CA 92866-3426

Mailing address

867 S Tustin St
Orange, CA 92866-3426
Phone (714) 771-1420

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
I20100304000542 CA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 7315082112 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7305CAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William H Nuesse M D and Mary Ann Nuesse D O a Medical Corporation CurrentSince Jan 24, 2000 Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

867 S Tustin St
Orange, CA 92866
Phone (714) 771-1420

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498348800000",
    "number": "1689633455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 S TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928663426",
            "telephone_number": "714-771-1420",
            "fax_number": "714-771-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 S TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928663426",
            "telephone_number": "714-771-1420",
            "fax_number": "714-771-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESSE",
        "first_name": "MARYANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2017-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "20A7305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.