Individual provider Active NPI

Jason Alan Dugan, MD, MBA

  • Internal Medicine Physician
  • Irvine, CA
National Provider Identifier
1750641874
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A120759 Issued in CA
Practice address
4050 Barranca Pkwy
Suite 200
Irvine, CA 92604-7706
Phone
(949) 551-1090
NPI assigned
May 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A120759 CA Primary

Addresses

Primary practice location

4050 Barranca Pkwy
Suite 200
Irvine, CA 92604-7706

Mailing address

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

Other practice location 1

26800 Crown Valley Pkwy Ste 325
Mission Viejo, CA 92691-6384
Phone (949) 364-6000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130824000256 CA Practitioner - Internal Medicine 8022251925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A120759CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients

Locations

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

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

4050 Barranca Pkwy
Ste 200
Irvine, CA 92604
Phone (949) 551-1090

Interoperability endpoints

  • Direct secure messaging: jdugan193140@direct.memorialcare.org

Organizations & group practices 1

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": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1750641874",
    "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": "4050 BARRANCA PKWY",
            "address_2": "SUITE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926047706",
            "telephone_number": "949-551-1090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26800 Crown Valley Pkwy Ste 325",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926916384",
            "country_code": "US",
            "telephone_number": "949-364-6000",
            "fax_number": "949-364-9561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "JASON",
        "middle_name": "ALAN",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A120759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.