NPIMap

Organization Active NPI

Integrated Critical Care and Pulmonary Specialists Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Orange, CA
National Provider Identifier
1902313919
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
INTEGRATED CRITICAL CARE AND PULMONARY SPECIALISTS INC.
Practice address
1100 W Stewart Dr
Orange, CA 92868-3849
Phone
(949) 354-3672
NPI assigned
Dec 29, 2017
Last updated
Oct 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Authorized official

Name
Lisa Kenefick Favor, CPA
Title
Accountant
Phone
(949) 829-8299

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU Primary
Pulmonary Disease Physician 207RP1001X NU

Addresses

Primary practice location

1100 W Stewart Dr
Orange, CA 92868-3849

Mailing address

24422 Avenida de la Carlota Ste 275
Laguna Hills, CA 92653-3669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180323001355 CA Part B Supplier - Clinic/Group Practice 7113289539 Receives reassigned benefits from 12 practitioners
Practice locations: Orange, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1902313919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24422 AVENIDA DE LA CARLOTA STE 275",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W STEWART DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849",
            "telephone_number": "949-354-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CRITICAL CARE AND PULMONARY SPECIALISTS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-29",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "FAVOR",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KENEFICK",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "949-829-8299",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.