Pavilion Neurology Medical Group Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PAVILION NEUROLOGY MEDICAL GROUP INC.

Practice address

1140 W la Veta Ave Ste 730
Orange, CA 92868-4229

Phone

(714) 541-6800

Fax

(714) 541-1591

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Miss Elsa Carmona

Title

Manager

Phone

(714) 541-6800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Interoperability endpoints

• Direct secure messaging: amirshokrae@pavnmg.allscriptsdirect.net
• Direct secure messaging: victortruong@pavnmg.allscriptsdirect.net
• Direct secure messaging: neelanthadesilva@pavnmg.allscriptsdirect.net
• Direct secure messaging: amral-hariri@pavnmg.allscriptsdirect.net
• Direct secure messaging: mayankpathak@pavnmg.allscriptsdirect.net

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amr Al-Hariri, M.D.

  • Neurology Physician
  • Templeton, CA
  • NPI 1497862254
  Medicare reassignment Care Compare group NPD
• Mayank Shami Pathak, M.D.

  • Neurology Physician
  • Orange, CA
  • NPI 1114959475
  Medicare reassignment Care Compare group NPD
• Amir Shokrae, M.D.

  • Specialist
  • Orange, CA
  • NPI 1306934112
  Medicare reassignment Care Compare group NPD
• Neelantha Menaka De Silva, M.D.

  • Neurology Physician
  • Fort Myers, FL
  • NPI 1407944002

  CA, Specialist

  Medicare reassignment Care Compare group NPD
• Victor Truong, PA

  • Physician Assistant
  • Orange, CA
  • NPI 1407448277
  Medicare reassignment Care Compare group
• Karly Janell Borunda, FNP

  • Family Nurse Practitioner
  • Orange, CA
  • NPI 1174179725
  Medicare reassignment NPD
• Nancy Chung Kamimura, FNP

  • Family Nurse Practitioner
  • Orange, CA
  • NPI 1063850212
  Medicare reassignment NPD

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972636009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE STE 730",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684229",
            "telephone_number": "714-541-6800",
            "fax_number": "714-541-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE STE 730",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684229",
            "telephone_number": "714-541-6800",
            "fax_number": "714-541-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION NEUROLOGY MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CARMONA",
        "authorized_official_first_name": "ELSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-541-6800",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Ross Paull, M.D.
• Nancy Ostos Paulsen
• Karine Pauzuolis, RN, BSN, MSN, CRNA
• Mia Pavia
• Pavilion Family Physicians Medical Group Inc.
• Pavilion Surgery Center LLC
• Paving Forward Family Therapy Inc.
• Arthur Pavlovsky, MD
• No Name Given Pawan
• Ramandeep Kaur Pawar

• Specialist in Orange, CA
• Providers in Orange, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.