Individual provider Active NPI

George V Dous

  • Cardiovascular Disease Physician
  • Lodi, CA
National Provider Identifier
1780936906
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A132794 Issued in CA
Practice address
999 S Fairmont Ave Ste 130
Lodi, CA 95240
Phone
(209) 336-2001
Fax
(209) 366-2022
NPI assigned
Oct 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X A132794 CA Primary

Addresses

Primary practice location

999 S Fairmont Ave Ste 130
Lodi, CA 95240

Mailing address

301 W Bastanchury Rd
Ste 240
Fullerton, CA 92835-3430
Phone (714) 853-1218

Other practice location 1

470 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1568

Other practice location 2

470 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1568

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
I20190809000704 CA Practitioner - Cardiovascular Disease (Cardiology) 5193006633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

301 W Bastanchury Rd
Suite 240
Fullerton, CA 92835-3430
Phone (714) 853-1218

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
99.32 of 100Reported as individual
Quality
97.74
Improvement activities
40
Cost
71.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A132794CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart to Heart Cardiology and Vascular of Orange County Inc. Cardiology CurrentSince Aug 1, 2021 Accepting new patients
Sameh Shenouda MD Inc. CurrentSince Feb 1, 2022 Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
University of California Irvine Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

301 W Bastanchury Rd
Ste 240
Fullerton, CA 92835
Phone (714) 220-8735

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

7963 Van Nuys Blvd
Ste 101
Panorama City, CA 91402
Phone (818) 909-9955

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEBFCD
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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 4

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": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1780936906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "STE 240",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353430",
            "telephone_number": "714-853-1218",
            "fax_number": "714-853-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S FAIRMONT AVE STE 130",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95240",
            "telephone_number": "209-336-2001",
            "fax_number": "209-366-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "470 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-1568",
            "fax_number": "718-270-2917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "470 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-1568",
            "fax_number": "718-270-2917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUS",
        "first_name": "GEORGE",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A132794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.