Newport Critical Care Physicians Medical Group Inc
Organization Active NPI Critical Care Medicine (Internal Medicine) Physician · Newport Beach, CA
NPI 1740220482 · NPPES record last updated Apr 11, 2024
Key facts
- NPI
- 1740220482
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician 207RC0200X
- Legal business name
- NEWPORT CRITICAL CARE PHYSICIANS MEDICAL GROUP INC
- Practice address
- One Hoag Drive
3 North Intensivist Office
Newport Beach, CA 92663-4162 - Phone
- (949) 764-6875
- Fax
- (949) 764-6874
- NPI assigned
- Jun 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Rebeca Laguna
- Title
- Credentialing Manager
- Phone
- (442) 600-5128
Practitioners 25
-
Mazda Aghamohammadi, M.D.
-
Abhinandan Anil Bharne, M.D.
-
Steven Lin, M.D.
-
Robert Rowe, M.D.
-
Usman S Shah, MD
-
Sam Tonthat, D.O.
-
Edwardo Torres, MD
-
Andre Vovan, MD
-
Vanessa Kitzis, MD
-
Franklin A Ho, M.D.
-
Michael Krutzik, MD
-
Herbert Rogove, DO
-
Dana Doan Ai Tran, M.D.
-
Kenneth Q Cruz, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000424 | CA | Part B Supplier - Clinic/Group Practice | 1052223682 |
Receives reassigned benefits from 18 practitioners Practice locations: Irvine, CA; Newport Beach, CA |
National Provider Directory
Locations
1 Hoag Dr
Ofc
Newport Beach, CA 92663
Phone (949) 764-6875
1 Hoag Dr
Ste 3
Newport Beach, CA 92663
Interoperability endpoints
- andre.vovan@oc.medicity.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Critical Care Medicine (Internal Medicine) Physician |
207RC0200X | Yes | ||
| Pulmonary Disease Physician |
207RP1001X |
Addresses
Primary practice location
One Hoag Drive
3 North Intensivist Office
Newport Beach, CA 92663-4162
Mailing address
PO Box 749226
Los Angeles, CA 90074-9226
Phone (949) 263-8620
Other practice location 1
16200 Sand Canyon Ave
Irvine, CA 92618-3714
Phone (462) 494-9764
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ02938Z | Other | CA | BLUE SHIELD OF CA |
| GR0090550 | Medicaid | CA |
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All providers in Newport Beach, CA · Critical Care Medicine (Internal Medicine) Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.