Individual provider Active NPI

Julie L Palmisano, MD

  • Pediatrics Physician
  • Newport Beach, CA
National Provider Identifier
1962654780
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A96319 Issued in CA
Practice address
510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663
Phone
(949) 791-3001
NPI assigned
Oct 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A96319 CA Primary

Addresses

Primary practice location

510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663

Mailing address

510 Superior Ave
Ste 200B
Newport Beach, CA 92663-3663
Phone (949) 791-3001

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
I20110713000460 CA Practitioner - Pediatric Medicine 4284829953 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96319CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Pediatrics CurrentSince May 30, 2011 Accepting new patients
Hoag Clinic CurrentSince Mar 1, 2019 Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

4900 Barranca Pkwy
Ste 103
Irvine, CA 92604
Phone (949) 726-0600

4900 Barranca Pkwy
Irvine, CA 92604
Phone (949) 726-0677

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

510 Superior Ave
Ste 200B
Newport Beach, CA 92663
Phone (800) 400-4624

510 Superior Ave
Ste 290
Newport Beach, CA 92663
Phone (949) 764-4500

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

15000 Kensington Park Dr
Ste 200
Tustin, CA 92782
Phone (714) 477-8310

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1962654780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "address_2": "STE 200B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "949-791-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "address_2": "STE 200B",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "949-791-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMISANO",
        "first_name": "JULIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A96319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.