Organization Active NPI

Newport Neurology

  • Neurology Physician
  • Newport Beach, CA
National Provider Identifier
1912028176
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEWPORT NEUROLOGY
Practice address
360 San Miguel Dr Ste 503
Newport Beach, CA 92660-7831
Phone
(949) 760-1640
Fax
(949) 760-1610
NPI assigned
Apr 3, 2007
Last updated
Sep 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Steven Wheeler, M.D.NPI 1225180615
Title
President
Phone
(949) 760-1640

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
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

360 San Miguel Dr Ste 503
Newport Beach, CA 92660-7831

Mailing address

1401 Avocado Ave
Suite 805
Newport Beach, CA 92660-7720
Phone (949) 760-1640

Other identifiers 1

IdentifierTypeStateIssuer
00G793770MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050609001167 CA Part B Supplier - Clinic/Group Practice 7911940986 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

1401 Avocado Ave
Ste 105
Newport Beach, CA 92660
Phone (949) 718-9292

1401 Avocado Ave
Ste 805
Newport Beach, CA 92660
Phone (714) 760-1640

360 San Miguel Dr
Ste 503
Newport Beach, CA 92660
Phone (949) 759-9515

Practitioners & affiliated clinicians

Practitioners 1

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1912028176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE",
            "address_2": "SUITE 805",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607720",
            "telephone_number": "949-760-1640",
            "fax_number": "949-760-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SAN MIGUEL DR STE 503",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607831",
            "telephone_number": "949-760-1640",
            "fax_number": "949-760-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-760-1640",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G793770",
            "state": "CA"
        }
    ],
    "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 Sep 19, 2024; 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.