Organization Active NPI

Baraye

  • Dermatology Physician
  • Irvine, CA
National Provider Identifier
1760174882
Registry record updated Jan 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BARAYE
Practice address
6865 Alton Pkwy Ste 210
Irvine, CA 92618-3741
Phone
(949) 800-8551
Fax
(657) 400-8008
NPI assigned
May 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2024

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

Authorized official

Name
Dr. Marjon Vatanchi, MDNPI 1073951109
Title
Chief Medical Officer
Phone
(949) 800-8551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

6865 Alton Pkwy Ste 210
Irvine, CA 92618-3741

Mailing address

6865 Alton Pkwy Ste 210
Irvine, CA 92618-3741
Phone (949) 800-8551

Other names 1

  • Irvine Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230712003286 CA Part B Supplier - Clinic/Group Practice 8123488996 Receives reassigned benefits from 5 practitioners
Practice locations: Irvine, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2303107Irvine Dermatology6865 Alton Pkwy, Ste 210, Irvine, CA 92618ComplianceJul 30, 2027

National Provider Directory

National Provider Directory

Locations

6865 Alton Pkwy
Ste 210
Irvine, CA 92618
Phone (949) 586-0004

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706400000000",
    "number": "1760174882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 ALTON PKWY STE 210",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183741",
            "telephone_number": "949-800-8551",
            "fax_number": "657-400-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6865 ALTON PKWY STE 210",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183741",
            "telephone_number": "949-800-8551",
            "fax_number": "657-400-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARAYE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A",
        "authorized_official_last_name": "VATANCHI",
        "authorized_official_first_name": "MARJON",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "949-800-8551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Irvine Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Irvine Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.