NEWPORT MESA MEDICAL GROUP, INC
NPI 1104836956
Internal Medicine in Costa Mesa, CA
About Newport Mesa Medical Group, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NEWPORT MESA MEDICAL GROUP, INC (NPI 1104836956) is a healthcare organization registered as an internal medicine in Costa Mesa, California and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through January 8, 2028 and lists Abdul A Khan, Owner Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Newport Mesa Medical Group, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Newport Mesa Medical Group, Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D1021035
Newport Mesa Medical Group Inc · Costa Mesa, CAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Newport Mesa Medical Group, Inc's NPI number?
The NPI number for Newport Mesa Medical Group, Inc is 1104836956. It was assigned to this organization in the NPPES registry on August 8, 2006.
Where is Newport Mesa Medical Group, Inc located?
Newport Mesa Medical Group, Inc is located at 275 Victoria St Ste 1E, Costa Mesa, CA 92627. The listed phone number is (949) 574-3615.
What is Newport Mesa Medical Group, Inc's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Newport Mesa Medical Group, Inc enrolled in Medicare?
Yes. Newport Mesa Medical Group, Inc is registered in the Medicare PECOS enrollment system.
When is Newport Mesa Medical Group, Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Newport Mesa Medical Group, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Newport Mesa Medical Group, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Newport Mesa Medical Group, Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D1021035) is associated with this NPI, valid through January 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Newport Mesa Medical Group, Inc was last updated on October 19, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Newport Mesa Medical Group, Inc · NPI 1104836956
Internal Medicine organization in Costa Mesa, California. Organization record, active in the CMS NPPES registry since August 8, 2006.
## Identity
- **NPI:** 1104836956 (Entity type: Organization)
- **Enumerated:** August 8, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Abdul Khan, OWNER PHYSICIAN
## Practice location
- **Address:** 275 VICTORIA ST, STE 1E, Costa Mesa, CA 92627-1906
- **Phone:** (949) 574-3615
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 19, 2010
- **Other identifiers:** Medicare PIN W15859
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104836956) · Data from the CMS NPPES public registry.