Individual provider Active NPI

Langston Tyler Holly, MD

  • Neurological Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1063437192
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A62574 Issued in CA
Practice address
300 Medical PLZ
#200
Los Angeles, CA 90095-0001
Phone
(310) 825-5111
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A62574 CA Primary

Addresses

Primary practice location

300 Medical PLZ
#200
Los Angeles, CA 90095-0001

Mailing address

5767 W Century Blvd
# 400
Los Angeles, CA 90045-5631
Phone (310) 825-5111

Other identifiers 1

IdentifierTypeStateIssuer
00A625740MedicaidCA

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
I20090416000484 CA Practitioner - Neurosurgery 5799832341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of California, Geffen School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355249491, 43 clinicians

Practice addresses (Care Compare)

1131 Wilshire Blvd
Suite 100
Santa Monica, CA 90401-2072
Phone (424) 259-7000

300 Medical PLZ
Los Angeles, CA 90095-0001
Phone (310) 825-5111

757 Westwood PLZ
Los Angeles, CA 90095-8358

Hospital & facility affiliations

  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Merit-based Incentive Payment System (MIPS)

Final score
83.91 of 100Reported as group
Quality
68.73
Promoting interoperability
100
Improvement activities
40
Cost
63.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion41
Laminectomy or laminotomy (partial removal of spine bones)52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A62574CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Neurological Surgery CurrentSince Feb 3, 2003 Accepting new patients
The Regents of the University of California Neurological Surgery CurrentSince Feb 3, 2003 Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

File 54206
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

1131 Wilshire Blvd
Ste 100
Santa Monica, CA 90401
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: lholly38240@direct.uclahealth.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 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1063437192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "# 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ",
            "address_2": "#200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLY",
        "first_name": "LANGSTON",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A62574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A625740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.