Individual provider Active NPI

Dwight E Hiscox, M.D.

  • Anesthesiology Physician
  • Glendale, CA
National Provider Identifier
1053458950
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G34805 Issued in CA
Practice address
1509 Wilson Ter
Glendale, CA 91206-4007
Phone
(818) 550-0900
Fax
(505) 293-1524
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G34805 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206-4007

Mailing address

PO Box 5486
Orange, CA 92863-5486
Phone (818) 550-0900

Other identifiers 1

IdentifierTypeStateIssuer
00G348050MedicaidCA

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
I20040709000374 CA Practitioner - Anesthesiology 8628969730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8000

Hospital & facility affiliations

  • Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G34805CAMDAnesthesiology Physician
34805CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Anesthesia Specialists a Medical Corporation Anesthesiology CurrentSince Sep 1, 2009 Accepting new patients
Dwight Hiscox, M.D., Inc. Anesthesiology PastSince Mar 18, 2004 Accepting new patients
Premier Home Health Care, Inc. PastSince Feb 9, 2004 Accepting new patients

Locations

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Homebound Health Care ServicesNorthridge, CA, CCN 058485 Home health agency Corporate Director (100%)
Operational/Managerial Control (100%)
Feb 6, 2006
Feb 6, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1053458950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5486",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635486",
            "telephone_number": "818-550-0900",
            "fax_number": "505-293-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-550-0900",
            "fax_number": "505-293-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISCOX",
        "first_name": "DWIGHT",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G34805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G348050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.