NPIMap

Individual provider Active NPI

Andrew J Hong, MD

  • Family Medicine Physician
  • San Juan Capistrano, CA
National Provider Identifier
1700877842
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A80562 Issued in CA
Practice address
31001 Rancho Viejo Rd.
Suite 200
San Juan Capistrano, CA 92675-8703
Phone
(949) 661-9611
Fax
(949) 443-6200
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A80562 CA Primary

Addresses

Primary practice location

31001 Rancho Viejo Rd.
Suite 200
San Juan Capistrano, CA 92675-8703

Mailing address

17360 Brookhurst St
Attn: MCMF - Credentialing Dept.
Fountain Valley, CA 92708-3720

Other identifiers 1

IdentifierTypeStateIssuer
00A805620MedicaidCA

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
I20031113000728 CA Practitioner - Family Practice 6305750464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

31001 Rancho Viejo Rd
Suite 200
San Juan Capistrano, CA 92675-8704
Phone (949) 661-9611

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A80562CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Feb 1, 2011 Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients
Children'S Hospital at Mission Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

31001 Rancho Viejo Rd
Ste 200
San Juan Capistrano, CA 92675
Phone (949) 661-9600

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ahong194070@direct.memorialcare.org

Organizations & group practices 9

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1700877842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "address_2": "ATTN: MCMF - CREDENTIALING DEPT.",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31001 RANCHO VIEJO RD.",
            "address_2": "SUITE 200",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926758703",
            "telephone_number": "949-661-9611",
            "fax_number": "949-443-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A80562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A805620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

Verify at the official NPI Registry.