Jack C Feng, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A64319 Issued in CA

Practice address

27871 Medical Center Rd
Suite 200
Mission Viejo, CA 92691-6404

Phone

(949) 364-5090

Fax

(949) 542-8710

NPI assigned

Dec 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Gastroenterology

Education

Ohio State University College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Mission Internal Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Mission Viejo, CA
  • NPI 1902884174
  NPD
• Providence Medical Foundation

  • Obstetrics & Gynecology Physician
  • Napa, CA
  • NPI 1205131950
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Mission Hospital Regional Medical Center

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Mission Internal Medical Group, Inc.

  • Physical Therapist
  • Laguna Niguel, CA
  • NPI 1649443169
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1710964481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27871 MEDICAL CENTER RD STE 240",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916406",
            "telephone_number": "949-364-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27871 MEDICAL CENTER RD",
            "address_2": "SUITE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916404",
            "telephone_number": "949-364-5090",
            "fax_number": "949-542-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENG",
        "first_name": "JACK",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A64319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A643190",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackfeng@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "27871 Medical Center Rd",
            "address_2": "SUITE 200",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard Lance Fein, LMFT
• Mary Jane Felch, MFT
• Mitra Felfeli
• Krista Fendrick, PA-C
• Jean M Feneis, O.D.
• Angela Fernandez
• Demetrio Dela Rosa Fernandez Jr., DMD
• Dylan Fernandez, DMD
• Jared Fernandez, ACSW, PPSC
• Rowena C. Fernandez, LCSW

• Gastroenterology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.