NPIMap

Individual provider Active NPI

Todd S Harris, MD

  • Vascular & Interventional Radiology Physician
  • Newport Beach, CA
National Provider Identifier
1710980677
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A105121 Issued in CA
Practice address
4501 Birch St
Newport Beach, CA 92660
Phone
(949) 221-0136
Fax
(949) 387-1136
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A105121 CA
Vascular & Interventional Radiology Physician 2085R0204X A105121 CA Primary

Addresses

Primary practice location

4501 Birch St
Newport Beach, CA 92660

Mailing address

PO Box 12139
Newport Beach, CA 92658-5053
Phone (949) 221-0136

Other identifiers 1

IdentifierTypeStateIssuer
171098067MedicaidMI

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
I20090112000130 CA Practitioner - General SurgeryPractitioner - Interventional Radiology 8224058177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Interventional Radiology
Education
Medical University of South Carolina College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4501 Birch St
Newport Beach, CA 92660-1990
Phone (949) 221-0136

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
69.75 of 100Reported as individual
Quality
21.67
Promoting interoperability
73
Improvement activities
40
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)25
Hernia repair (minimally invasive)88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105121CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Vascular Access, a Medical Corporation Vascular & Interventional Radiology CurrentSince Sep 1, 2008 Accepting new patients
Westchester Medical Group, P.C. Current Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Redington Medical Associates Surgery Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
San Miguel Hospital Corporation Past Accepting new patients
San Miguel Clinic Corp Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Newport Diagnostic Radiology, Inc Past Accepting new patients
Quantum Medical Radiology PC Past Accepting new patients
James F McGuckin MD Inc Vascular & Interventional Radiology Past Accepting new patients

Locations

12827 Harbor Blvd
Ste G1
Garden Grove, CA 92840
Phone (714) 534-1680

12555 Garden Grove Blvd
Ste 200
Garden Grove, CA 92843
Phone (714) 534-1679

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

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 1

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1710980677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12139",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585053",
            "telephone_number": "949-221-0136",
            "fax_number": "949-387-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 BIRCH ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-221-0136",
            "fax_number": "949-387-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TODD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A105121",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A105121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171098067",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.