Individual provider Active NPI

Mark F. Sedrak, M.D.

  • Specialist
  • Torrance, CA
National Provider Identifier
1053545285
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A95140 Issued in CA
Practice address
21350 Hawthorne Blvd
Suite 176
Torrance, CA 90503-5605
Phone
(310) 540-6908
Fax
(310) 540-6721
NPI assigned
May 1, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A95140 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X A95140 CA

Addresses

Primary practice location

21350 Hawthorne Blvd
Suite 176
Torrance, CA 90503-5605

Mailing address

21350 Hawthorne Blvd.
Suite 176
Torrance, CA 90503
Phone (310) 540-6908

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20101018000836 CA Practitioner - Neurosurgery 4183817562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

910 Maple St
Redwood City, CA 94063-2034
Phone (650) 299-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Redwood City Hospital, Redwood City, CA, CCN 050541

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Jul 17, 2011 Accepting new patients
County of Los Angeles Single Specialty CurrentSince Feb 19, 2011 Accepting new patients
Permanente Medical Group Inc Single Specialty CurrentSince Jul 17, 2011 Accepting new patients
County of Los Angeles CurrentSince Feb 19, 2011 Accepting new patients
Permanente Medical Group Inc Single Specialty Current Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1800 Harrison St
Fl 7
Oakland, CA 94612

910 Maple St
Redwood City, CA 94063
Phone (650) 299-2040

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

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": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1053545285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21350 HAWTHORNE BLVD.",
            "address_2": "SUITE 176",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90503",
            "telephone_number": "310-540-6908",
            "fax_number": "310-540-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21350 HAWTHORNE BLVD",
            "address_2": "SUITE 176",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035605",
            "telephone_number": "310-540-6908",
            "fax_number": "310-540-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDRAK",
        "first_name": "MARK",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-01",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A95140",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A95140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1150 Veterans Blvd",
            "city": "Redwood City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.