NPIMap

Individual provider Active NPI

Irvin S. Benowitz, D.O.

  • Geriatric Medicine (Family Medicine) Physician
  • Burbank, CA
National Provider Identifier
1083749212
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
20A4228 Issued in CA
Practice address
191 S Buena Vista St
Ste. 420
Burbank, CA 91505-4554
Phone
(818) 557-7399
Fax
(818) 848-1543
NPI assigned
Feb 21, 2007
Last updated
Apr 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A4228 CA
Geriatric Medicine (Family Medicine) Physician 207QG0300X 20A4228 CA Primary
Aerospace Medicine Physician 2083A0100X 20A4228 CA

Addresses

Primary practice location

191 S Buena Vista St
Ste. 420
Burbank, CA 91505-4554

Mailing address

777 Flower St Ste a
Glendale, CA 91201-3000
Phone (818) 637-2000

Other identifiers 1

IdentifierTypeStateIssuer
00AX42280MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Aaa Comprehensive Healthcare Inc PastSince Dec 24, 2023 Accepting new patients
All State Hospice Care, Inc. Family Medicine PastSince Jan 1, 2025 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
On Time Hospice Care Inc. Past Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Family Medicine Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: irvin.benowitz.p1@direct.aaachc800.nextgenshare.com
  • Direct secure messaging: irvin.benowitz.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 6

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1083749212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013000",
            "telephone_number": "818-637-2000",
            "fax_number": "818-242-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "address_2": "STE. 420",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054554",
            "telephone_number": "818-557-7399",
            "fax_number": "818-848-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENOWITZ",
        "first_name": "IRVIN",
        "middle_name": "S.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4228",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "20A4228",
            "primary": true
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "CA",
            "license": "20A4228",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX42280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.