NPIMap

Organization Active NPI

Newport Harbor Pathology Medical Group Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Newport Beach, CA
National Provider Identifier
1790711927
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
FNP 23213 Issued in CA
Legal business name
NEWPORT HARBOR PATHOLOGY MEDICAL GROUP INC
Practice address
2901 W Coast Hwy Ste 200
Newport Beach, CA 92663-4045
Phone
(949) 891-1297
Fax
(949) 258-4354
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Howard D Epstein, MDNPI 1003852674
Title
President
Phone
(949) 764-5635

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
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X FNP 23213 CA Primary

Addresses

Primary practice location

2901 W Coast Hwy Ste 200
Newport Beach, CA 92663-4045

Mailing address

2901 W Coast Hwy Ste 200
Newport Beach, CA 92663-4045
Phone (949) 891-1297

Other identifiers 2

IdentifierTypeStateIssuer
GR0076400MedicaidCA
ZZZ51273ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041022001124 CA Part B Supplier - Clinic/Group Practice 1456312396 Receives reassigned benefits from 32 practitioners
Practice locations: Laguna Beach, CA; Orange, CA; Newport Beach, CA; Mission Viejo, CA; Irvine, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
05D1100910Newport Harbor Pathology2901 W Coast Hwy, Ste 200, Newport Beach, CA 92663ComplianceJul 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Newport Harbor Pathology Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

805 W La Veta Ave
Ste 1044
Orange, CA 92868

Practitioners & affiliated clinicians

Practitioners 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1790711927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W COAST HWY STE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634045",
            "telephone_number": "949-891-1297",
            "fax_number": "949-258-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W COAST HWY STE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634045",
            "telephone_number": "949-891-1297",
            "fax_number": "949-258-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT HARBOR PATHOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "EPSTEIN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-764-5635",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "FNP 23213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0076400",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ51273Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.