Individual provider Active NPI

Bennett Cua, M.D.

  • Cardiovascular Disease Physician
  • Mission Viejo, CA
National Provider Identifier
1962791772
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A155737 Issued in CA
Practice address
26800 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691
Phone
(949) 364-3330
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 54830 CT
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X A155737 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691

Mailing address

26800 Crown Valley Pkwy Ste 250
Mission Viejo, CA 92691-8038

Other practice location 1

20 York St
Yale-New Haven Hospital
New Haven, CT 06510-3220
Phone (203) 573-7354

Other practice location 2

20 York St
Yale-New Haven Hospital
New Haven, CT 06510-3220
Phone (203) 573-7354

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcua1373976@oc.providencedirect.org

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
I20180904000915 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 9032406665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155737CAMDCardiovascular Disease Physician
54830CTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jul 1, 2018 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jul 1, 2018 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

26800 Crown Valley Pkwy
Ste 250
Mission Viejo, CA 92691
Phone (949) 364-3570

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bcua1373976@oc.providencedirect.org

Organizations & group practices 5

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 5

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": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1962791772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY STE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-364-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_2": "Yale-New Haven Hospital",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-573-7354",
            "fax_number": "203-573-6707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York St",
            "address_2": "Yale-New Haven Hospital",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-573-7354",
            "fax_number": "203-573-6707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUA",
        "first_name": "BENNETT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "54830",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A155737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcua1373976@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy Ste 250",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.