Individual provider Active NPI

Sheri Koplik, M.D.

  • Cardiovascular Disease Physician
  • Mission Viejo, CA
National Provider Identifier
1902959612
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A96659 Issued in CA
Practice address
26800 Crown Valley Pkwy
Suite 250
Mission Viejo, CA 92691-6384
Phone
(949) 364-3570
Fax
(949) 364-3430
NPI assigned
Jan 18, 2007
Last updated
Nov 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A96659 CA
Cardiovascular Disease Physician 207RC0000X A96659 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy
Suite 250
Mission Viejo, CA 92691-6384

Mailing address

26800 Crown Valley Pkwy
Suite 250
Mission Viejo, CA 92691-6384
Phone (949) 364-3570

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skoplik1373975@oc.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000644 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6901983618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96659CAMDClinical Social Worker
A96659CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince May 15, 2016 Accepting new patients
Providence Medical Foundation CurrentSince May 15, 2016 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

26800 Crown Valley Pkwy
Ste 250
Mission Viejo, CA 92691
Phone (949) 364-3570

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1902959612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-364-3570",
            "fax_number": "949-364-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-364-3570",
            "fax_number": "949-364-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPLIK",
        "first_name": "SHERI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A96659",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A96659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skoplik1373975@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy",
            "address_2": "Suite 250",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.