Active NPI
Anson J. Levine, PH.D
- Psychologist
- Santa Monica, CA
National Provider Identifier
1083730717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 7090
- Practice address
- 1460 7TH St
Santa Monica, CA 90401-2629 - Phone
- (310) 454-0583
- Fax
- (310) 459-2423
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 7090 | CA | Primary |
Addresses
Primary practice location
1460 7TH St
Santa Monica, CA 90401-2629
Mailing address
572 Dryad Rd
Santa Monica, CA 90402-1318
Phone (310) 454-0583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081220000019 | CA | Practitioner - Psychologist Billing Independently | 8820150113 | Practice locations: Santa Monica, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
572 Dryad Rd
Santa Monica, CA 90402-1318
Phone (310) 454-0583
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 7090 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083730717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "572 DRYAD RD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904021318",
"telephone_number": "310-454-0583",
"fax_number": "310-459-2423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1460 7TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904012629",
"telephone_number": "310-454-0583",
"fax_number": "310-459-2423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "ANSON",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 7090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.