Individual provider Active NPI

Noelle Joy Kraus, PA

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1780220772
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA57526 Issued in CA
Practice address
20301 SW Birch St Ste 100
Newport Beach, CA 92660-1754
Phone
(949) 251-1502
Fax
(949) 251-1522
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA57526 CA Primary

Addresses

Primary practice location

20301 SW Birch St Ste 100
Newport Beach, CA 92660-1754

Mailing address

20301 SW Birch St Ste 100
Newport Beach, CA 92660-1754
Phone (949) 251-1502

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200102001318 CA Practitioner - Physician Assistant 7911331756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthcare Service Partners IncGroup PAC ID 0648557363, 10 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (833) 477-2677

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (833) 477-2677

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57526CAMDPharmacist
PA57526CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Assistant Specialists-California Inc Physician Assistant PastSince Oct 8, 2023 Accepting new patients

Organizations & group practices 2

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 2

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": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1780220772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20301 SW BIRCH ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601754",
            "telephone_number": "949-251-1502",
            "fax_number": "949-251-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20301 SW BIRCH ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601754",
            "telephone_number": "949-251-1502",
            "fax_number": "949-251-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUS",
        "first_name": "NOELLE",
        "middle_name": "JOY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.