Organization Active NPI

Care Connectors Medical Group Inc

  • Internal Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1902386642
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CARE CONNECTORS MEDICAL GROUP INC
Practice address
4695 Macarthur CT # 1112a
Newport Beach, CA 92660-1882
Phone
(949) 642-5513
Fax
(949) 642-9479
NPI assigned
Aug 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Vinod Tony Kannarkat, MDNPI 1891966412
Title
Owner
Phone
(949) 642-5513

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X CA Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X CA

Addresses

Primary practice location

4695 Macarthur CT # 1112a
Newport Beach, CA 92660-1882

Mailing address

4695 Macarthur CT # 1112a
Newport Beach, CA 92660-1882
Phone (949) 642-5513

Other practice location 1

500 Marquette Ave NW
Albuquerque, NM 87102-5340
Phone (949) 642-5513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230420000918 CA Part B Supplier - Clinic/Group Practice 0143685461 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA
O20230713002679 NM Part B Supplier - Clinic/Group Practice 0143685461 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

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": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1902386642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4695 MACARTHUR CT # 1112A",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601882",
            "telephone_number": "949-642-5513",
            "fax_number": "949-642-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4695 MACARTHUR CT # 1112A",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601882",
            "telephone_number": "949-642-5513",
            "fax_number": "949-642-9479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Marquette Ave NW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871025340",
            "country_code": "US",
            "telephone_number": "949-642-5513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARE CONNECTORS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "KANNARKAT",
        "authorized_official_first_name": "VINOD",
        "authorized_official_middle_name": "TONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-642-5513",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.