Individual provider Active NPI

Leif Anders Havton, MD

  • Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1063437887
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A51291 Issued in CA
Practice address
300 Medical Plaza
#B200
Los Angeles, CA 90095-0001
Phone
(310) 794-1195
Fax
(310) 794-7491
NPI assigned
Jul 13, 2006
Last updated
Jan 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X A51291 CA
Neurology Physician 2084N0400X A51291 CA Primary

Addresses

Primary practice location

300 Medical Plaza
#B200
Los Angeles, CA 90095-0001

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
00A512910MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110628000672 CA Practitioner - Neurology 3577741263 Reassigns benefits to 1 organization
I20200219002593 NY Practitioner - Neurology 3577741263 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of CurrentSince May 25, 2011 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 29, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 29, 2019 Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1063437887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLAZA",
            "address_2": "#B200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-794-1195",
            "fax_number": "310-794-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVTON",
        "first_name": "LEIF",
        "middle_name": "ANDERS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "A51291",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A51291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A512910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.