Individual provider Active NPI

Stacy Chia

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1780873562
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A101574 Issued in CA
Practice address
14150 Culver Dr Ste 100
Irvine, CA 92604-0322
Phone
(949) 552-4584
Fax
(949) 551-5612
NPI assigned
Oct 17, 2007
Last updated
Dec 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A101574 CA Primary

Addresses

Primary practice location

14150 Culver Dr Ste 100
Irvine, CA 92604-0322

Mailing address

14150 Culver Dr Ste 100
Irvine, CA 92604-0322
Phone (949) 552-4584

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
I20120813000629 CA Practitioner - Family Practice 0648426353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

100 S Anaheim Blvd
Suite 101
Anaheim, CA 92805-3848
Phone (714) 826-1200

14150 Culver Dr
Suite 100
Irvine, CA 92604-0322
Phone (949) 552-4584

15464 Goldenwest St
Westminster, CA 92683-6149
Phone (714) 891-9008

18102 Culver Dr
Irvine, CA 92612-2730
Phone (657) 241-8220

23512 Madero
Mission Viejo, CA 92691-2743
Phone (949) 583-1600

24268 El Toro Rd
Laguna Woods, CA 92637-3435
Phone (657) 241-8455

24401 Health Ctr Dr
Suite 300
Laguna Hills, CA 92653-3615
Phone (949) 770-4115

29472 Avenida de Las Bandera
Rancho Santa Margarita, CA 92688-2651
Phone (949) 459-9968

30492 Gateway PL
Suite 110
Rancho Mission Viejo, CA 92694-1862
Phone (657) 241-8435

4050 Barranca Pkwy
Suite 200
Irvine, CA 92604-1723
Phone (949) 551-1090

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

9122 Adams Ave
Huntington Beach, CA 92646-3405
Phone (714) 378-0900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A101574CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Nov 9, 2019 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past 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

14150 Culver Dr
Ste 100
Irvine, CA 92604
Phone (949) 552-4584

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: schia529055@direct.memorialcare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1780873562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040322",
            "telephone_number": "949-552-4584",
            "fax_number": "949-551-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040322",
            "telephone_number": "949-552-4584",
            "fax_number": "949-551-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIA",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.