Individual provider Active NPI

Carey L O'Bryan IV, M.D.

  • Cardiovascular Disease Physician
  • Newport Beach, CA
National Provider Identifier
1912996356
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A89153 Issued in CA
Practice address
415 Old Newport Blvd
Suite 200
Newport Beach, CA 92663-4248
Phone
(949) 548-9611
Fax
(949) 548-9958
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A89153 CA
Nuclear Cardiology Physician 207UN0901X A89153 CA
Cardiovascular Disease Physician 207RC0000X A89153 CA Primary

Addresses

Primary practice location

415 Old Newport Blvd
Suite 200
Newport Beach, CA 92663-4248

Mailing address

415 Old Newport Blvd
Suite 200
Newport Beach, CA 92663-4248
Phone (949) 548-9611

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
I20060125000696 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear Medicine 9436173796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Nuclear Medicine
Education
Georgetown University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Newport Heart Medical Group IncGroup PAC ID 5799723011, 9 clinicians

Practice addresses (Care Compare)

415 Old Newport Blvd
Suite 200
Newport Beach, CA 92663-4252
Phone (949) 548-9611

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
90.04 of 100Reported as group
Quality
96.64
Promoting interoperability
96
Improvement activities
40
Cost
73.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A89153CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Heart Medical Group Inc Specialist CurrentSince Aug 1, 2005 Accepting new patients

Locations

415 Old Newport Blvd
Ste 200
Newport Beach, CA 92663
Phone (949) 548-9611

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

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

Organizations & group practices 1

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 1

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912996356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 OLD NEWPORT BLVD",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634248",
            "telephone_number": "949-548-9611",
            "fax_number": "949-548-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 OLD NEWPORT BLVD",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634248",
            "telephone_number": "949-548-9611",
            "fax_number": "949-548-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "CAREY",
        "middle_name": "L",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2023-03-07",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A89153",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "A89153",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A89153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.