Individual provider Active NPI

Daniel Wohlgelernter, M.D.

  • Specialist
  • Santa Monica, CA
National Provider Identifier
1003836651
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G55314 Issued in CA
Practice address
1301 20TH St
Suite 590
Santa Monica, CA 90404-2050
Phone
(310) 315-0101
Fax
(310) 453-4145
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G55314 CA Primary

Addresses

Primary practice location

1301 20TH St
Suite 590
Santa Monica, CA 90404-2050

Mailing address

2021 Santa Monica Blvd
Suite 212E
Santa Monica, CA 90404-2225
Phone (310) 401-3390

Other identifiers 2

IdentifierTypeStateIssuer
00G553140MedicaidCA
952976030OtherCAGROUP TAX IDENTIFICATION

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
I20101006000299 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4688624737 Reassigns benefits to 1 organization
Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Yale University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2021 Santa Monica Blvd
Suite 212E
Santa Monica, CA 90404-2225
Phone (310) 401-3390

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging Center of Southern California CurrentSince Aug 26, 2017 Accepting new patients
Santa Monica Preventive Cardiology Medical Group, Inc CurrentSince Jun 28, 2020 Accepting new patients
The Regents of the University of California Past Accepting new patients
Providence Saint John's Health Center Past Accepting new patients
Lisa C Moore MD Inc PastSince Jun 28, 2020 Accepting new patients

Locations

2827 Wilshire Blvd
Santa Monica, CA 90403
Phone (310) 453-1489

2021 Santa Monica Blvd
Ste 212E
Santa Monica, CA 90404
Phone (310) 829-4327

Organizations & group practices 5

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 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1003836651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUITE 212E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042225",
            "telephone_number": "310-401-3390",
            "fax_number": "310-453-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST",
            "address_2": "SUITE 590",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042050",
            "telephone_number": "310-315-0101",
            "fax_number": "310-453-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHLGELERNTER",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G55314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G553140",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX IDENTIFICATION",
            "identifier": "952976030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.