Individual provider Active NPI

Gregory James Frazer, AU.D. , PH.D.

  • Audiologist
  • Los Angeles, CA
National Provider Identifier
1023051588
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU651 Issued in CA
Practice address
11645 Wilshire Blvd Ste 601a
Los Angeles, CA 90025-1708
Phone
(310) 909-0180
Fax
(310) 919-3181
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AU651 CA
Audiologist 231H00000X AU651 CA Primary

Addresses

Primary practice location

11645 Wilshire Blvd Ste 601a
Los Angeles, CA 90025-1708

Mailing address

11645 Wilshire Blvd
Suite# 600
Los Angeles, CA 90025-1708
Phone (310) 477-5558

Other identifiers 1

IdentifierTypeStateIssuer
AU0006510MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510001040 CA Practitioner - Qualified Audiologist 2163316126 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Wayne State University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Hearing and Balance., IncGroup PAC ID 8820084973, 6 clinicians

Practice addresses (Care Compare)

11645 Wilshire Blvd
Los Angeles, CA 90025-1708
Phone (310) 477-5558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
651CAMDMidwife
AU651CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Hearing & Balance Center Specialist CurrentSince Sep 21, 2019 Accepting new patients
Hearing Associates, Inc Specialist CurrentSince Jul 26, 2005 Accepting new patients
Pacific Hearing & Balance., Inc Specialist CurrentSince Sep 21, 2019 Accepting new patients
Hearing Associates, Inc. Specialist Current Accepting new patients
Pacific Hearing , Inc Specialist CurrentSince Apr 1, 2003 Accepting new patients
Pacific Hearing & Balance, Inc. Specialist Past Accepting new patients
Matt Michaels, M.S. Audiologist Past Accepting new patients
Saint John'S Health Clinic Specialist PastSince Aug 23, 2020 Accepting new patients
Carissa Bennett, Aud, Inc Audiologist Past Accepting new patients

Locations

3801 Las Posas Rd
Ste 106B
Camarillo, CA 93010
Phone (805) 383-8995

11645 Wilshire Blvd
#601B
Los Angeles, CA 90025
Phone (310) 477-5558

11645 Wilshire Blvd
Ste 601B
Los Angeles, CA 90025

11645 Wilshire Blvd
Ste 601
Los Angeles, CA 90025
Phone (310) 909-0180

11645 Wilshire Blvd
Ste 601A
Los Angeles, CA 90025
Phone (310) 477-5558

4644 Lincoln Blvd
Ste 409
Marina del Rey, CA 90292
Phone (310) 574-1116

18433 Roscoe Blvd
Ste 204
Northridge, CA 91325
Phone (818) 727-7020

1700 N Rose Ave
Ste 460
Oxnard, CA 93030
Phone (805) 983-0395

2876 Sycamore Dr
Ste 303
Simi Valley, CA 93065
Phone (805) 527-7320

11645 Wilshire Blvd
Ste 60
West Los Angeles, CA 90025
Phone (310) 477-5558

11645 Wilshire Blvd
Ste 600
West Los Angeles, CA 90025
Phone (310) 477-5558

Organizations & group practices 9

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1023051588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE# 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-477-5558",
            "fax_number": "310-477-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD STE 601A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-909-0180",
            "fax_number": "310-919-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZER",
        "first_name": "GREGORY",
        "middle_name": "JAMES",
        "credential": "AU.D. , PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "AU651",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AU0006510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.