NPIMap

Individual provider Active NPI

Tiva Hanjan, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Mission Viejo, CA
National Provider Identifier
1689729253
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A81862 Issued in CA
Practice address
26401 Crown Valley Pkwy Ste 101
Mission Viejo, CA 92691-6302
Phone
(949) 348-4000
Fax
(949) 348-7466
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A81862 CA Primary

Addresses

Primary practice location

26401 Crown Valley Pkwy Ste 101
Mission Viejo, CA 92691-6302

Mailing address

26401 Crown Valley Pkwy Ste 101
Mission Viejo, CA 92691-6302
Phone (949) 348-4000

Other identifiers 1

IdentifierTypeStateIssuer
0000263442OtherHIHMSA

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
I20081022000374 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 3375648918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Stanford University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Orthopedic Medical GroupGroup PAC ID 2365426517, 17 clinicians

Practice addresses (Care Compare)

26401 Crown Valley Pkwy
Suite 101
Mission Viejo, CA 92691-6302
Phone (949) 348-4000

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81862CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Orthopedic Medical Group Physical Medicine & Rehabilitation CurrentSince Mar 15, 2010 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Portner Orthopedic Rehabilitation Incorporated Physical Medicine & Rehabilitation PastSince Sep 8, 2024 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Scott J. Miscovich MD, LLC PastSince Apr 20, 2003 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

26401 Crown Valley Pkwy
Ste 101
Mission Viejo, CA 92691
Phone (949) 348-4000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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 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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1689729253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY STE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916302",
            "telephone_number": "949-348-4000",
            "fax_number": "949-348-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY STE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916302",
            "telephone_number": "949-348-4000",
            "fax_number": "949-348-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANJAN",
        "first_name": "TIVA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A81862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000263442",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.