Innovatemed Medical Group PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INNOVATEMED MEDICAL GROUP PC

Practice address

615 E Chapman Ave Ste 300
Orange, CA 92866-1643

Phone

(714) 639-4012

Fax

(714) 639-4018

NPI assigned

May 26, 2023

Last updated

Mar 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Arasi Prasad

Title

Administrator

Phone

(714) 639-4012

Specialties & licenses 1

Addresses

Other names 1

• Orange Novacare Medical Group PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Samy Farag, MD

  • Internal Medicine Physician
  • Inglewood, CA
  • NPI 1104983873
  Medicare reassignment NPD
• Bryn Jarald Henderson, D.O.

  • Family Medicine Physician
  • Orange, CA
  • NPI 1447296694
  Medicare reassignment NPD
• Nicholas E. Sieveking, MD

  • Specialist
  • Nashville, TN
  • NPI 1548250434

  CA

  Medicare reassignment NPD
• Jenna Knapp

  • Physician Assistant
  • Orange, CA
  • NPI 1528885449
  Medicare reassignment

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1730871732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E CHAPMAN AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E CHAPMAN AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661643",
            "telephone_number": "714-639-4012",
            "fax_number": "714-639-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATEMED MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-26",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "PRASAD",
        "authorized_official_first_name": "ARASI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "714-639-4012",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Novacare Medical Group PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Melissa Kristin Ingkom, N.P.
• Gayle Ingram, PTA
• Maria Guadalupe Iniestra
• Joshua Iniguez
• Elle Louise Inman
• Innovtech Histopathology Services
• Innvigorate Integrative Wellness Institute
• Inpsycht Psychological Services, PC
• Inpsycht Services
• Jula Inrig, MD

• Family Medicine Physician in Orange, CA
• Providers in Orange, 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 Mar 5, 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.