Individual provider Active NPI

Suad Kapetanovic, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1003845702
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A85682 Issued in CA
Practice address
1520 San Pablo St Ste 1652
Los Angeles, CA 90033-5310
Phone
(323) 442-6000
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A85682 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 1652
Los Angeles, CA 90033-5310

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address suad.kapetanovic@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20070611000532 CA Practitioner - Psychiatry 8527166834 Reassigns benefits to 2 organizations
Practice locations: Laguna Beach, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A85682CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2006 Accepting new patients
Special Service for Groups, Inc. CurrentSince Jan 20, 2018 Accepting new patients
Special Service for Groups, Inc. CurrentSince Jan 20, 2018 Accepting new patients
Usc Care Medical Group, Inc Psychiatry CurrentSince Aug 1, 2006 Accepting new patients
Special Service for Groups, Inc. Current Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Ste 1652
Los Angeles, CA 90033
Phone (323) 442-6000

2250 Alcazar St
Ste 2200
Los Angeles, CA 90089
Phone (323) 442-4000

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

515 Columbia Ave
Ste 200
Los Angeles, CA 90017
Phone (213) 249-9388

1516 San Pablo St
Los Angeles, CA 90033
Phone (323) 276-3705

1520 San Pablo St
Ste 4100
Los Angeles, CA 90033
Phone (323) 442-6000

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

Interoperability endpoints

  • Direct secure messaging: suad.kapetanovic@direct.usc.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1003845702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 1652",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPETANOVIC",
        "first_name": "SUAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A85682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "suad.kapetanovic@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 1652",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.