Individual provider Active NPI

Alexandra Edelman, MD

  • Dermatology Physician
  • Brea, CA
National Provider Identifier
1700240249
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A167597 Issued in CA
Practice address
955 W Imperial Hwy Ste 200
Brea, CA 92821-3812
Phone
(714) 626-6310
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A167597 CA Primary

Addresses

Primary practice location

955 W Imperial Hwy Ste 200
Brea, CA 92821-3812

Mailing address

955 W Imperial Hwy Ste 200
Brea, CA 92821-3812
Phone (714) 626-6310

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
I20200903000667 CA Practitioner - Dermatology 8820360597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
George Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatologist Medical Group of North County IncGroup PAC ID 7315849981, 19 clinicians

Practice addresses (Care Compare)

3613 Vista Way
Oceanside, CA 92056-4522
Phone (760) 758-5340

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision118
Removal of tissue1-10
Removal of skin lesions846
Removal of skin cancer708
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy248

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167597CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Dermatologist Medical Group of North County, Inc Dermatology CurrentSince Jan 20, 2023 Accepting new patients
Providence Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Aug 1, 2022 Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

955 W Imperial Hwy
Ste 200
Brea, CA 92821
Phone (714) 449-6900

1200 Garden View Rd
Ste 108
Encinitas, CA 92024
Phone (760) 942-1311

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

3613 Vista Way
Oceanside, CA 92056
Phone (760) 758-5340

11943 El Camino Real
Ste 220
San Diego, CA 92130
Phone (760) 758-5340

Interoperability endpoints

  • Direct secure messaging: aedelman@northcounty.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1700240249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 200",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213812",
            "telephone_number": "714-626-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 200",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213812",
            "telephone_number": "714-626-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELMAN",
        "first_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A167597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.