Individual provider Active NPI

Yousef W Ireifej, M.D.

  • Family Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1962693598
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A100115 Issued in CA
Practice address
12665 Garden Grove Blvd Ste 502a
Garden Grove, CA 92843-1919
Phone
(714) 537-7800
Fax
(714) 537-7633
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A100115 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 502a
Garden Grove, CA 92843-1919

Mailing address

7955 Westminster Blvd
Westminster, CA 92683-4001
Phone (714) 379-3221

Other identifiers 2

IdentifierTypeStateIssuer
0A1001150MedicaidCA
WA100115AMedicaidCA

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
I20070919000997 CA Practitioner - Family Practice 2567556624 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Wound Care IncGroup PAC ID 7315480001, 2 clinicians
Pathway Medical Group IncGroup PAC ID 5092776690, 17 clinicians

Practice addresses (Care Compare)

1202 Monte Vista Ave
Suite 6
Upland, CA 91786-8209
Phone (888) 982-0847

501 S Beach Blvd
Anaheim, CA 92804-1810
Phone (714) 816-0540

7955 Westminster Blvd
Westminster, CA 92683-4001
Phone (714) 379-3221

Hospital & facility affiliations

  • Primemed Home Health Care, Inc Home health agency, Sun Valley, CA, CCN 559340
  • Maxcare Hospice Hospice, Westminster, CA, CCN 551689
  • 24/7 Care at Home - Hospice Hospice, Westminster, CA, CCN 751637
  • Supportive Hospice Care Inc Hospice, Upland, CA, CCN 551755
  • 24/7 Care at Home - Hospice Hospice, Ontario, CA, CCN 751576
  • Anaheim Healthcare Center, LLC Nursing home, Anaheim, CA, CCN 055984
  • Beach Creek Post-Acute Nursing home, Anaheim, CA, CCN 555388
  • Garden Park Care Center Nursing home, Garden Grove, CA, CCN 555667
  • Leisure Court Nursing Center Nursing home, Anaheim, CA, CCN 555520
  • Sea Cliff Healthcare Center Nursing home, Huntington Beach, CA, CCN 555249

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue419

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100115CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Wound Care, Inc CurrentSince May 1, 2024 Accepting new patients
Pathway Medical Group, Inc Family Medicine Current Accepting new patients
Pathway Medical Group, Inc Family Medicine Current Accepting new patients
Pathway Medical Group, Inc. CurrentSince Sep 4, 2007 Accepting new patients
Pathway Medical Group, Inc Family Medicine Current Accepting new patients

Locations

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

12665 Garden Grove Blvd
Ste 502
Garden Grove, CA 92843
Phone (714) 534-3900

12665 Garden Grove Blvd
Ste 502AB
Garden Grove, CA 92843
Phone (714) 537-7800

12681 Haster St
Garden Grove, CA 92840
Phone 71494122593

12665 Garden Grove Blvd
Ste 502A
Garden Grove, CA 92843
Phone (714) 534-3900

1202 Monte Vista Ave
Ste 6
Upland, CA 91786
Phone (310) 435-7575

7955 Westminster Blvd
Westminster, CA 92683
Phone (714) 379-2411

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beach Creek Post-AcuteAnaheim, CA, CCN 555388 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Oct 1, 2022
Oct 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 9

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1962693598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7955 WESTMINSTER BLVD",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834001",
            "telephone_number": "714-379-3221",
            "fax_number": "714-379-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 502A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431919",
            "telephone_number": "714-537-7800",
            "fax_number": "714-537-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IREIFEJ",
        "first_name": "YOUSEF",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A100115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1001150",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WA100115A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.