SOUTH COAST MEDICAL GROUP FAMILY AND SPORTS MEDICINE
NPI 1649337221
Clinic/Center - Primary Care in Aliso Viejo, CA

Q: What is South Coast Medical Group Family And Sports Medicine's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since January 02, 2007

5 JOURNEY STE 130, ALISO VIEJO, CA 92656(949) 360-1069(949) 389-8968 Get Directions Write a Review

NPPES record last updated: July 30, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About South Coast Medical Group Family And Sports Medicine NPPES

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

SOUTH COAST MEDICAL GROUP FAMILY AND SPORTS MEDICINE (NPI 1649337221) is a healthcare organization registered as a primary care in Aliso Viejo, California and active in the NPI registry since January 2007. The organization lists Johnna Gherardini, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1649337221

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameSOUTH COAST MEDICAL GROUP FAMILY AND SPORTS MEDICINE

Location Address5 JOURNEY STE 130Aliso Viejo, CA 92656-5330

Mailing Address5 Journey Ste 130Aliso Viejo, CA 92656-5330 · (949) 360-1069 · Fax (949) 389-8968

Phone(949) 360-1069

Fax(949) 389-8968

Organization SubpartNo

Authorized OfficialJohnna GherardiniExecutive Director · (949) 360-1069

Enumeration DateJanuary 2, 2007

Last NPPES UpdateJuly 30, 2015

✔ NPI 1649337221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

5 JOURNEY STE 130, Aliso Viejo, CA 92656

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Other Identifiers 6

Other1932284478CA · Eric Clark, Md

Medicare UPINY06380CA

Other1861586554CA · Shannon O'connor, Md

Medicare ID-Type UnspecifiedW17141CA

Other1619061397CA · John Cheng, Md

Other1598723058CA · Archanna Bhogill, Md

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

South Coast Medical Group Family And Sports Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to South Coast Medical Group Family And Sports Medicine, which bills Medicare for the services this clinician delivers.

Clinician (1)

Shannon O Connor, M.D

Family Practice

NPI 1861586554

5 JOURNEY SUITE 130
Aliso Viejo, CA 92656

(949) 360-1069

✔ PECOS✔ Accepts Medicare0.3 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 South Coast Medical Group Family And Sports Medicine's NPI number?

The NPI number for South Coast Medical Group Family And Sports Medicine is 1649337221. It was assigned to this organization in the NPPES registry on January 2, 2007.

Where is South Coast Medical Group Family And Sports Medicine located?

South Coast Medical Group Family And Sports Medicine is located at 5 Journey Ste 130, Aliso Viejo, CA 92656. The listed phone number is (949) 360-1069.

What is South Coast Medical Group Family And Sports Medicine's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is South Coast Medical Group Family And Sports Medicine enrolled in Medicare?

Yes. South Coast Medical Group Family And Sports Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Coast Medical Group Family And Sports Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to South Coast Medical Group Family And Sports Medicine. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for South Coast Medical Group Family And Sports Medicine was last updated on July 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.