Individual provider Active NPI

Kristin Elizabeth Nesburn, MD

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1003827056
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A60925 Issued in CA
Practice address
8635 W 3Rd Street
#390W
Los Angeles, CA 90048-6101
Phone
(310) 652-1133
Fax
(310) 652-4353
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A60925 CA Primary

Addresses

Primary practice location

8635 W 3Rd Street
#390W
Los Angeles, CA 90048-6101

Mailing address

8635 W 3Rd Street
#390W
Los Angeles, CA 90048-6101
Phone (310) 652-1133

Other identifiers 1

IdentifierTypeStateIssuer
00A609250MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000229 CA Practitioner - Ophthalmology 5698783710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Perelman School of Med at the University of Pennsylvania, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Eye Institute a Medical CorpGroup PAC ID 7012955107, 6 clinicians

Practice addresses (Care Compare)

6330 San Vicente Blvd
Suite 408
Los Angeles, CA 90048-5462
Phone (310) 652-1133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
American Eye Institute a Medical Corp Ophthalmology CurrentSince Mar 31, 2006 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

6330 San Vicente Blvd
Ste 408
Los Angeles, CA 90048
Phone (310) 652-1133

8635 W 3rd St
Ste 390W
Los Angeles, CA 90048
Phone (310) 652-1133

8635 W 3rd St
Ste 390
West Hollywood, CA 90048
Phone (310) 652-1133

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1003827056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W 3RD STREET",
            "address_2": "#390W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-652-1133",
            "fax_number": "310-652-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD STREET",
            "address_2": "#390W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-652-1133",
            "fax_number": "310-652-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESBURN",
        "first_name": "KRISTIN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A60925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A609250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.