Pediatrics & Neonatology Medical Group of Orange County Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

180024 Issued in CA

Legal business name

PEDIATRICS & NEONATOLOGY MEDICAL GROUP OF ORANGE COUNTY INC

Practice address

12665 Garden Grove Blvd
Suite 713
Garden Grove, CA 92843-1921

Phone

(714) 537-6595

Fax

(714) 537-2176

NPI assigned

May 12, 2008

Last updated

Oct 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Sweidan, M.D.NPI 1265494835

Title

President/Ceo/Owner

Phone

(714) 915-4656

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Sweidan, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Garden Grove, CA
  • NPI 1265494835
  Medicare reassignment Authorized official
• Armea Botros, M.D.

  • Pediatrics Physician
  • Los Angeles, CA
  • NPI 1871739979
  Medicare reassignment

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1982871729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8500",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926588500",
            "telephone_number": "714-537-6595",
            "fax_number": "714-537-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 713",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431921",
            "telephone_number": "714-537-6595",
            "fax_number": "714-537-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS & NEONATOLOGY MEDICAL GROUP OF ORANGE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "SWEIDAN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT/CEO/OWNER",
        "authorized_official_telephone_number": "714-915-4656",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "180024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A213320",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A943300",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C350690",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00PA142210",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00PA183200",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093291",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00PA177430",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A378880",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A446640",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G268130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Marie Pearce, M.A., CCC-SLP
• Linda L Pearce, PNP
• Daisha Pearson
• Gemma Pedersen
• Pediatrics & Neonatology Medical Group of Orange County
• Joanna Pedraza, LVN
• Santiago Pedraza
• Pedro Morales DDS, Inc.
• Dillon T Pedroza
• Joseph Pedroza

• Pediatrics Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.