Organization Active NPI

Joanna Kopacz, MD Inc.

  • Infectious Disease Physician
  • Laguna Hills, CA
National Provider Identifier
1851753701
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
JOANNA KOPACZ, MD INC.
Practice address
24411 Health Center Dr Ste 560
Laguna Hills, CA 92653-3687
Phone
(949) 218-7251
NPI assigned
Mar 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Joanna Kopacz, MDNPI 1275792368
Title
President
Phone
(949) 218-7251

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
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

24411 Health Center Dr Ste 560
Laguna Hills, CA 92653-3687

Mailing address

PO Box 29491
Saint Louis, MO 63126-7491

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160608001668 CA Part B Supplier - Clinic/Group Practice 8921398694 Receives reassigned benefits from 1 practitioner
Practice locations: Laguna Hills, CA

National Provider Directory

National Provider Directory

Locations

27800 Medical Center Rd
Ste 264
Mission Viejo, CA 92691
Phone (949) 218-7251

Practitioners & affiliated clinicians

Practitioners 1

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": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1851753701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29491",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631267491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24411 HEALTH CENTER DR STE 560",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533687",
            "telephone_number": "949-218-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNA KOPACZ, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "KOPACZ",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-218-7251",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.