Organization Active NPI

Oc Pediatrics Medical Group Inc

  • Pediatrics Physician
  • Foothill Ranch, CA
National Provider Identifier
1912265257
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A94330 Issued in CA
Legal business name
OC PEDIATRICS MEDICAL GROUP INC
Practice address
26700 Towne Centre Dr
Ste 150
Foothill Ranch, CA 92610-2844
Phone
(949) 837-7337
Fax
(949) 837-7347
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Amina Hassan-Elsayed, MDNPI 1417179318
Title
President
Phone
(949) 241-0117

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
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A94330 CA Primary

Addresses

Primary practice location

26700 Towne Centre Dr
Ste 150
Foothill Ranch, CA 92610-2844

Mailing address

26700 Towne Centre Dr
Ste 150
Foothill Ranch, CA 92610-2844
Phone (949) 837-7337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120517000424 CA Part B Supplier - Clinic/Group Practice 4183887763 Receives reassigned benefits from 1 practitioner
Practice locations: Foothill Ranch, 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
05D2043619Oc Pediatrics Medical Group Inc26700 Towne Centre Dr Ste 150, Foothill Ranch, CA 92610Certificate of waiverJul 5, 2028

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1912265257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26700 TOWNE CENTRE DR",
            "address_2": "STE 150",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926102844",
            "telephone_number": "949-837-7337",
            "fax_number": "949-837-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26700 TOWNE CENTRE DR",
            "address_2": "STE 150",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926102844",
            "telephone_number": "949-837-7337",
            "fax_number": "949-837-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OC PEDIATRICS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "HASSAN-ELSAYED",
        "authorized_official_first_name": "AMINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-241-0117",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A94330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foothill Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.