NPIMap

Individual provider Active NPI

Adam M Wass, M.D.

  • Family Medicine Physician
  • Costa Mesa, CA
National Provider Identifier
1831140938
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A87070 Issued in CA
Practice address
722 Baker St
Costa Mesa, CA 92626-4320
Phone
(714) 557-6300
Fax
(714) 996-9567
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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 A87070 CA Primary

Addresses

Primary practice location

722 Baker St
Costa Mesa, CA 92626-4320

Mailing address

2742 Dow Ave
Tustin, CA 92780-7242
Phone (714) 665-1600

Other identifiers 1

IdentifierTypeStateIssuer
00A870700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725000932 CA Practitioner - Family Practice 2163458647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2002
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)

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87070CAMDPharmacist
A87070CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Feb 1, 2011 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients
Children'S Hospital at Mission Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients
Saddleback Memorial Medical Center 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

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

17251 17th St
Ste B
Tustin, CA 92780
Phone (657) 241-8580

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: awass177799@direct.memorialcare.org

Organizations & group practices 10

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 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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1831140938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 DOW AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807242",
            "telephone_number": "714-665-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 BAKER ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264320",
            "telephone_number": "714-557-6300",
            "fax_number": "714-996-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASS",
        "first_name": "ADAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A87070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A870700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.