Organization Active NPI

Huntington Beach Internal Medicine Group Inc

  • Specialist
  • Newport Beach, CA
National Provider Identifier
1902948771
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HUNTINGTON BEACH INTERNAL MEDICINE GROUP INC
Practice address
1501 Superior Ave
#111
Newport Beach, CA 92663-3600
Phone
(949) 274-8030
Fax
(949) 642-3127
NPI assigned
Feb 12, 2007
Last updated
Oct 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Authorized official

Name
Mrs. Terri Leuenberger
Title
Office Manager
Phone
(714) 842-4492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1501 Superior Ave
#111
Newport Beach, CA 92663-3600

Mailing address

1501 Superior Ave
#111
Newport Beach, CA 92663-3600
Phone (949) 274-8030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050719001154 CA Part B Supplier - Clinic/Group Practice 0446287635 Receives reassigned benefits from 3 practitioners
Practice locations: Newport Beach, CA

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
05D0706644Huntington Beach Internal Medicine GRP1501 Superior Ave #111, Newport Beach, CA 92663Certificate of waiverDec 23, 2027

National Provider Directory

National Provider Directory

Locations

17822 Beach Blvd
Ste 473
Huntington Beach, CA 92647
Phone (714) 274-9536

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJEAA

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1902948771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE",
            "address_2": "#111",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633600",
            "telephone_number": "949-274-8030",
            "fax_number": "949-642-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE",
            "address_2": "#111",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633600",
            "telephone_number": "949-274-8030",
            "fax_number": "949-642-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTINGTON BEACH INTERNAL MEDICINE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "LEUENBERGER",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-842-4492",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.