Individual provider Active NPI

Matthew Nienaber, D.O.

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1033535182
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A14759 Issued in CA
Practice address
1821 Wilshire Blvd Ste 100
Santa Monica, CA 90403-5627
Phone
(310) 575-3100
Fax
(310) 575-3102
NPI assigned
Mar 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A14759 CA Primary

Addresses

Primary practice location

1821 Wilshire Blvd Ste 100
Santa Monica, CA 90403-5627

Mailing address

1821 Wilshire Blvd Ste 100
Santa Monica, CA 90403-5627
Phone (310) 575-3100

Other practice location 1

355 Abbott St Ste 100
Salinas, CA 93901-4484
Phone (831) 751-7070

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnienaber292479@oc.providencedirect.org

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
I20170911003106 CA Practitioner - Internal Medicine 8224301346 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians
Svmhs ClinicsGroup PAC ID 1456592351, 258 clinicians

Practice addresses (Care Compare)

1821 Wilshire Blvd
Suite 100
Santa Monica, CA 90403-5627
Phone (310) 575-3100

355 Abbott St
Suite 100
Salinas, CA 93901-4484
Phone (831) 751-7070

Hospital & facility affiliations

  • Providence Home Health la County South Home health agency, Torrance, CA, CCN 557447
  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290
  • Salinas Valley Health Medical Center Hospital, Salinas, CA, CCN 050334

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14759CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Nationwide Vitals, Medical Corporation Internal Medicine CurrentSince Jan 22, 2026 Accepting new patients

Locations

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

11669 Santa Monica Blvd
Ste 110
Los Angeles, CA 90025
Phone (310) 237-8760

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2020 Santa Monica Blvd
Ste 300
Santa Monica, CA 90404
Phone (310) 582-7312

1821 Wilshire Blvd
Ste 100
Santa Monica, CA 90403
Phone (310) 575-3100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mnienaber292479@oc.providencedirect.org

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 4

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": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1033535182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035627",
            "telephone_number": "310-575-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035627",
            "telephone_number": "310-575-3100",
            "fax_number": "310-575-3102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Abbott St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939014484",
            "country_code": "US",
            "telephone_number": "831-751-7070",
            "fax_number": "831-751-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIENABER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-13",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A14759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnienaber292479@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1821 Wilshire Blvd Ste 100",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904035627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.