NPIMap

Organization Active NPI

University of California Irvine

  • General Acute Care Hospital
  • Fountain Valley, CA
National Provider Identifier
1821002007
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
06000109 Issued in CA
Legal business name
UNIVERSITY OF CALIFORNIA IRVINE
Practice address
17100 Euclid St
Fountain Valley, CA 92708-4004
Phone
(714) 966-7200
NPI assigned
Jul 27, 2006
Organization subpart
Yes
Parent organization
UNIVERSITY OF CALIFORNIA IRVIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Randolph Perseverance Siwabessy
Title
Vice President and Chief Financial
Phone
(714) 456-5180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 06000109 CA Primary

Addresses

Primary practice location

17100 Euclid St
Fountain Valley, CA 92708-4004

Mailing address

1500 S Douglass Rd
Suite 200, RT 183
Anaheim, CA 92806-6911
Phone (714) 456-6245

Other identifiers 7

IdentifierTypeStateIssuer
ZZZA3021ZOtherBS OF CALIFORNIA
11-1714706MedicaidCA
019264300OtherAETNA US HEALTHCARE (NATI
000415OtherHUMANA
050570B000000OtherSECTION 1011
003106-0001OtherPACIFICARE OF CALIFORNIA
8965OtherCOVENTRY HEALTH CARE KANS

Other names 2

  • UCI Health - Fountain Valley Doing business as
  • Fountain Valley Regional Hospital & Medical Center Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address roi@hs.uci.edu Direct

Care Compare: Hospital

Medicare Care Compare
Listed as
Uci Health - Fountain ValleyCCN 050570
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
Terminated Voluntary: merger or closure, Apr 1, 2025From the Provider of Services file
Emergency services
No

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address. The facility is not in the current Medicare enrollment files, which can mean its Medicare enrollment has ended (or, for VA and military hospitals, that it does not enroll).

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
05D0581647Uci Health - Fountain Valley17100 Euclid St, Fountain Valley, CA 92708AccreditationJan 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Regents of the University of California42 organizations share this tax ID, including this one
Part of
Regents of the University of California

Other organizations with this tax ID 41

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

View all 41

Locations

11190 Warner Ave
Ste 214
Fountain Valley, CA 92708
Phone (714) 966-8118

11190 Warner Ave
Ste 106
Fountain Valley, CA 92708
Phone (714) 966-8118

11160 Warner Ave
Ste 211
Fountain Vly, CA 92708
Phone (714) 966-8091

File 57545
Los Angeles, CA 90074

1310 W Stewart Dr
Ste 215
Orange, CA 92868
Phone (714) 997-5000

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1821002007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLASS RD",
            "address_2": "SUITE 200, RT 183",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928066911",
            "telephone_number": "714-456-6245",
            "fax_number": "714-456-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084004",
            "telephone_number": "714-966-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA IRVINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF CALIFORNIA IRVI",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "SIWABESSY",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_middle_name": "PERSEVERANCE",
        "authorized_official_title_or_position": "VICE PRESIDENT AND CHIEF FINANCIAL",
        "authorized_official_telephone_number": "714-456-5180"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "06000109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF CALIFORNIA",
            "identifier": "ZZZA3021Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11-1714706",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE (NATI",
            "identifier": "019264300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "000415",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECTION 1011",
            "identifier": "050570B000000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE OF CALIFORNIA",
            "identifier": "003106-0001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH CARE KANS",
            "identifier": "8965",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roi@hs.uci.edu",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17100 Euclid St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927084004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UCI Health - Fountain Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UCI Health - Fountain Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fountain Valley Regional Hospital & Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.