1. Home
  2. Directory
  3. California
  4. Orange
  5. Family Medicine
  6. NPI Profile

SENIOR DOC GEORGIA, PC
NPI 1134990682
Family Medicine in Orange, CA

Active since January 12, 2024
2592 N SANTIAGO BLVD, ORANGE, CA 92867(855) 434-7763(949) 281-5550 Get Directions Write a Review

NPPES record last updated: January 12, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Senior Doc Georgia, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SENIOR DOC GEORGIA, PC (NPI 1134990682) is a healthcare organization registered as a family medicine in Orange, California and active in the NPI registry since January 2024. The organization lists Angelica L Soto, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1134990682
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSENIOR DOC GEORGIA, PC
Location Address2592 N SANTIAGO BLVDOrange, CA 92867-1862
Mailing Address2592 N Santiago BlvdOrange, CA 92867-1862 · (855) 434-7763 · Fax (949) 281-5550
Phone(855) 434-7763
Fax(949) 281-5550
Organization SubpartNo
Authorized OfficialAngelica L SotoCredentialing Specialist · (855) 434-7763
Enumeration DateJanuary 12, 2024
NPPES CertifiedJanuary 12, 2024
✔ NPI 1134990682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2592 N SANTIAGO BLVD, Orange, CA 92867
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Senior Doc Georgia, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Senior Doc Georgia, PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Jeffrey Thomas
Internal Medicine
NPI 1932337136
2592 N SANTIAGO BLVD
Orange, CA 92867
(855) 434-7763
✔ PECOS✔ Accepts MedicareSame address
Meredith Bock, MD
Neurology
NPI 1447612940
505 PARNASSUS AVE
San Francisco, CA 94143
(818) 648-6941
✔ PECOS✔ Accepts Medicare375 mi
Kellie Pacheco
Nurse Practitioner
NPI 1326728668
1710 PATTERSON ST
Nashville, TN 37203
(615) 327-1085
✔ PECOS✔ Accepts Medicare1,760 mi
Fenia Philemond, NP
Nurse Practitioner
NPI 1386135283
3590 COBB PKWY NW STE 401
Acworth, GA 30101
(678) 492-8230
✔ PECOS✔ Accepts Medicare1,895 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 Senior Doc Georgia, PC's NPI number?

The NPI number for Senior Doc Georgia, PC is 1134990682. It was assigned to this organization in the NPPES registry on January 12, 2024.

Where is Senior Doc Georgia, PC located?

Senior Doc Georgia, PC is located at 2592 N Santiago Blvd, Orange, CA 92867. The listed phone number is (855) 434-7763.

What is Senior Doc Georgia, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Senior Doc Georgia, PC enrolled in Medicare?

Yes. Senior Doc Georgia, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Senior Doc Georgia, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Senior Doc Georgia, PC, in Internal Medicine, Neurology and Nurse Practitioner. 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Senior Doc Georgia, PC was last updated on January 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.