Senior Doc New Jersey PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SENIOR DOC NEW JERSEY PC

Practice address

5 Hutton Centre Dr Ste 950
Santa Ana, CA 92707-8714

Phone

(714) 702-5145

Fax

(949) 281-5550

NPI assigned

Aug 28, 2024

Organization subpart

No

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

Authorized official

Name

Angelica L Soto

Title

Credentialing Specialist

Phone

(714) 702-5145

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 6

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

• Meredith Bock, MD

  • Neurology Physician
  • San Francisco, CA
  • NPI 1447612940

  NJ

  Medicare reassignment
• Jeffrey Thomas

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1932337136

  NJ

  Medicare reassignment
• Kellie Pacheco

  • Family Nurse Practitioner
  • Nashville, TN
  • NPI 1326728668

  NJ

  Medicare reassignment
• Christine M Padilla, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Ridgefield, CT
  • NPI 1386897262

  NJ

  Medicare reassignment
• Jonathan Michael Day, RN, CRNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Ana, CA
  • NPI 1306508502

  Single Specialty

  NPD (past)
• Alexi Yarashevich, NP

  • Family Nurse Practitioner
  • Placentia, CA
  • NPI 1306340831

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1700610094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HUTTON CENTRE DR STE 950",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927078714",
            "telephone_number": "714-702-5145",
            "fax_number": "949-281-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HUTTON CENTRE DR STE 950",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927078714",
            "telephone_number": "714-702-5145",
            "fax_number": "949-281-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR DOC NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "SOTO",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "714-702-5145"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senior Doc Indiana PC
• Senior Doc Integrated Med, PC
• Senior Doc Iowa PC
• Senior Doc Kentucky PSC
• Senior Doc Medical PC
• Senior Doc North Carolina PC
• Senior Doc Pennsylvania PC
• Senior Doc Utah PC
• Senior Doc Vermont PC
• Senior Doc Virginia PC

• Family Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.