NPIMap

Individual provider Active NPI

Maneesh A Bansal, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1063615102
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A100339 Issued in CA
Practice address
5540 N Figueroa St
Los Angeles, CA 90042-4120
Phone
(323) 478-1101
NPI assigned
Jun 6, 2007
Last updated
Sep 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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 A100339 CA Primary

Addresses

Primary practice location

5540 N Figueroa St
Los Angeles, CA 90042-4120

Mailing address

5540 N Figueroa St
Los Angeles, CA 90042-4120
Phone (323) 478-1101

Other identifiers 1

IdentifierTypeStateIssuer
A100339OtherCAMEDICAL LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000306 CA Practitioner - Internal Medicine 9032219860 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100339CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jagan N. Bansal, M.D., Inc. CurrentSince Nov 20, 2012 Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Eladh, LP Past Accepting new patients
Mervat S. Bakhoum, D.D.S. Past Accepting new patients
Forward HCG Pearland LLC PastSince Oct 1, 2023 Accepting new patients
Vista del Sol Postacute Care PastSince Apr 17, 2023 Accepting new patients
Alta Los Angeles Hospitals, Inc. Past Accepting new patients
Hospice of St John Inc PastSince May 5, 2016 Accepting new patients
Ashley Clinical Diagnostic Laboratory Inc PastSince Nov 1, 2020 Accepting new patients

Locations

5540 N Figueroa St
Los Angeles, CA 90042
Phone (323) 478-1101

Ownership & related parties

All facility ownership & control disclosures 10

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

FacilityTypeRoleSince
Camden Postacute Care, IncCampbell, CA, CCN 555838 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer (100%)
Operational/Managerial Control (100%)		 Apr 17, 2023
Mar 1, 2014
Mar 1, 2014
Fresno Postacute CareFresno, CA, CCN 555426 Skilled nursing facility 5% Or Greater Indirect Ownership Interest Jan 1, 2019
Northgate Postacute CareSan Rafael, CA, CCN 056430 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (33.33%)
Corporate Officer (33.33%)
Operational/Managerial Control (33.33%)		 Apr 17, 2023
Mar 30, 2015
Mar 30, 2015
California Post-Acute CareLynwood, CA, CCN 055052 Skilled nursing facility Corporate Officer Aug 21, 2015
Ceres Postacute CareCeres, CA, CCN 055935 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
Operational/Managerial Control (100%)		 Apr 17, 2023
Mar 30, 2015
Mar 30, 2015
Mar 30, 2015
North Starr Postacute CareTurlock, CA, CCN 555347 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
W-2 Managing Employee (50%)
Operational/Managerial Control (50%)		 Apr 17, 2023
Mar 30, 2015
Mar 3, 2015
Mar 30, 2015
Mar 30, 2015
Main West Postacute CareTurlock, CA, CCN 055475 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer (50%)
Operational/Managerial Control (50%)		 Apr 17, 2023
Mar 30, 2015
Mar 30, 2015
Riverside Postacute CareRiverside, CA, CCN 555330 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director
Operational/Managerial Control		 Apr 17, 2023
Nov 23, 2015
Nov 23, 2015
Nov 23, 2015
Northvine Postacute CareSanta Rosa, CA, CCN 056259 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
Operational/Managerial Control (50%)		 Apr 17, 2023
Jun 15, 2017
Jun 15, 2017
Jun 15, 2017
Thrive Rehabilitation of PearlandPearland, TX, CCN 676436 Skilled nursing facility 5% Or Greater Direct Ownership Interest (50%) Oct 1, 2023

Owned or controlled facilities with NPI records 10

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

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1063615102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424120",
            "telephone_number": "323-478-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424120",
            "telephone_number": "323-478-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "MANEESH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A100339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE #",
            "identifier": "A100339",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.