Individual provider Active NPI

Virginia E Kimonis, MD

  • Clinical Genetics (M.D.) Physician
  • Orange, CA
National Provider Identifier
1912964925
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
C52311 Issued in CA
Practice address
101 The City Dr S # Zc4482
Division of Genetics and Metabolism
Orange, CA 92868-3201
Phone
(714) 456-5792
Fax
(714) 456-5330
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 156969 MA
Clinical Biochemical Genetics Physician 207SG0202X 156969 MA
Pediatrics Physician 208000000X 156969 MA
Clinical Genetics (M.D.) Physician 207SG0201X C52311 CA Primary

Addresses

Primary practice location

101 The City Dr S # Zc4482
Division of Genetics and Metabolism
Orange, CA 92868-3201

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (714) 456-2986

Other identifiers 1

IdentifierTypeStateIssuer
127230MedicaidMA

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
I20061013000572 CA Practitioner - Pediatric Medicine 0648276618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC Regents Uci Dept of PediatricsGroup PAC ID 5395649222, 8 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52311CAMDClinical Genetics (M.D.) Physician
156969MAMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Uci Dept of Pediatrics Pediatrics CurrentSince Jul 1, 2006 Accepting new patients
University of California Irvine Past Accepting new patients
St Johns Hospital of the Hospital Sisters of the Third Order of St F Past Accepting new patients
University of California Irvine Past Accepting new patients
Pediatric Subspecialty Faculty, Inc. Pediatrics Past Accepting new patients

Locations

2650 Elm Ave
Ste 301
Long Beach, CA 90806
Phone (310) 424-1963

101 The City Dr S
Bldg 30
Orange, CA 92868
Phone (714) 456-6966

101 The City Dr S
Bldg 1
Orange, CA 92868
Phone (714) 456-2911

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

200 S Manchester Ave
Ste 600
Orange, CA 92868
Phone (714) 456-2911

101 The City Dr S
#4482
Orange, CA 92868
Phone (714) 456-5631

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Organizations & group practices 5

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

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1912964925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S # ZC4482",
            "address_2": "DIVISION OF GENETICS AND METABOLISM",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5792",
            "fax_number": "714-456-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMONIS",
        "first_name": "VIRGINIA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MA",
            "license": "156969",
            "primary": false
        },
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "MA",
            "license": "156969",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "156969",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "C52311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127230",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.