Individual provider Active NPI

William Robert Bartok, MD

  • Dermatology Physician
  • Mission Viejo, CA
National Provider Identifier
1962546713
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
C29940 Issued in CA
Practice address
26302 La Paz Road
Suite 214
Mission Viejo, CA 92691-5328
Phone
(949) 830-9530
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X C29940 CA Primary

Addresses

Primary practice location

26302 La Paz Road
Suite 214
Mission Viejo, CA 92691-5328

Mailing address

26302 La Paz Road
Suite 214
Mission Viejo, CA 92691-5328
Phone (949) 830-9530

Other identifiers 2

IdentifierTypeStateIssuer
00C299401MedicaidCA
W4545OtherPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962546713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ ROAD",
            "address_2": "SUITE 214",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915328",
            "telephone_number": "949-830-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ ROAD",
            "address_2": "SUITE 214",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915328",
            "telephone_number": "949-830-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOK",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C29940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C299401",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "W4545",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.