Individual provider Active NPI

Edward J Block, M.D.

  • Gastroenterology Physician
  • Mission Viejo, CA
National Provider Identifier
1811973860
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G45827 Issued in CA
Practice address
27871 Medical Center Rd
Suite 200
Mission Viejo, CA 92691-6404
Phone
(949) 364-5090
Fax
(949) 542-8710
NPI assigned
Dec 21, 2005
Last updated
Jan 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G45827 CA
Gastroenterology Physician 207RG0100X G45827 CA Primary

Addresses

Primary practice location

27871 Medical Center Rd
Suite 200
Mission Viejo, CA 92691-6404

Mailing address

26522 La Alameda
Suite 120
Mission Viejo, CA 92691-6330
Phone (949) 282-1671

Other identifiers 1

IdentifierTypeStateIssuer
00G458270MedicaidCA

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
I20050922001206 CA Practitioner - Gastroenterology 7012953789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Icahn School of Medicine at Mount Sinai, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

27799 Medical Ctr Rd
Mission Viejo, CA 92691-6400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy122
Upper gastrointestinal (GI) endoscopy for acid reflux118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45827CAMDGeneral Practice Dentistry
G45827CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jan 1, 2013 Accepting new patients
Providence Medical Foundation CurrentSince Jan 1, 2013 Accepting new patients
Mission Internal Medical Group, Inc. Current Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

279 Imperial Hwy
Ste 730
Fullerton, CA 92835
Phone (714) 449-4841

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

27799 Medical Center Rd
Ste 310
Mission Viejo, CA 92691
Phone (949) 364-5090

27871 Medical Center Rd
Ste 200
Mission Viejo, CA 92691
Phone (949) 347-8314

27871 Medical Center Rd
Ste 240
Mission Viejo, CA 92691
Phone (949) 364-5090

665 Camino de los Mares
Ste 210
San Clemente, CA 92673
Phone (949) 240-6772

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1811973860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA",
            "address_2": "SUITE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330",
            "telephone_number": "949-282-1671",
            "fax_number": "949-367-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27871 MEDICAL CENTER RD",
            "address_2": "SUITE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916404",
            "telephone_number": "949-364-5090",
            "fax_number": "949-542-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G45827",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G45827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G458270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.