Individual provider Active NPI

David J Perkowski, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Laguna Hills, CA
National Provider Identifier
1942226279
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
C38668 Issued in CA
Practice address
24411 Health Center Dr
Suite 680
Laguna Hills, CA 92653-3651
Phone
(949) 268-4568
Fax
(949) 455-2795
NPI assigned
Jul 13, 2006
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X C38668 CA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 22773 NV

Addresses

Primary practice location

24411 Health Center Dr
Suite 680
Laguna Hills, CA 92653-3651

Mailing address

17360 Brookhurst St
Attn: MCMF - Credentialing Department
Fountain Valley, CA 92708-3720

Other practice location 1

7190 S Cimarron Rd
Las Vegas, NV 89113-2171
Phone (702) 675-3240

Other identifiers 2

IdentifierTypeStateIssuer
00C386680MedicaidCA
C38668OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050228000259 CA Practitioner - Cardiac Surgery 8022061449 Reassigns benefits to 2 organizations
I20211104002607 KS Practitioner - Thoracic SurgeryPractitioner - Cardiovascular Disease (Cardiology) 8022061449 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C38668CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Thoracic and Cardiovascular Surgeons a Med Corp CurrentSince Jan 1, 1995 Accepting new patients
Memorialcare Medical Foundation CurrentSince Dec 1, 2013 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
JFK Memorial Hospital, Inc. Past Accepting new patients
Hi-Desert Medical Center Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

24411 Health Center Dr
Ste 680
Laguna Hills, CA 92653
Phone (949) 268-4568

1310 W Stewart Dr
Ste 503
Orange, CA 92868
Phone (714) 532-0793

1180 N Indian Canyon Dr
Ste E318
Palm Springs, CA 92262
Phone (760) 327-5300

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1942226279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "address_2": "ATTN: MCMF - CREDENTIALING DEPARTMENT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24411 HEALTH CENTER DR",
            "address_2": "SUITE 680",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533651",
            "telephone_number": "949-268-4568",
            "fax_number": "949-455-2795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7190 S Cimarron Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891132171",
            "country_code": "US",
            "telephone_number": "702-675-3240",
            "fax_number": "702-982-6347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKOWSKI",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "C38668",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NV",
            "license": "22773",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C386680",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "C38668",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.