Individual provider Active NPI

Marc David Wishingrad, MD

  • Gastroenterology Physician
  • Santa Monica, CA
National Provider Identifier
1093764359
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G69602 Issued in CA
Practice address
2001 Santa Monica Blvd
Suite 360W
Santa Monica, CA 90404-2102
Phone
(310) 453-1871
Fax
(310) 453-3910
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G69602 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd
Suite 360W
Santa Monica, CA 90404-2102

Mailing address

2001 Santa Monica Blvd
Suite 360W
Santa Monica, CA 90404-2102
Phone (310) 453-1871

Other identifiers 1

IdentifierTypeStateIssuer
00G696020MedicaidCA

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
I20060329000452 CA Practitioner - Gastroenterology 5193799450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of California, Geffen School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

1919 Santa Monica Blvd
Suite 200
Santa Monica, CA 90404-1955
Phone (310) 582-7900

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290
  • Cedar-Sinai Marina del Rey Hospital Hospital, Marina del Rey, CA, CCN 050740

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy132
Upper gastrointestinal (GI) endoscopy for acid reflux122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69602CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Feb 1, 2015 Accepting new patients
William N. Katkov, M.D., Inc. Gastroenterology Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients
Danice Hertz MD Inc Gastroenterology Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Marc D Wishingrad MD Inc Gastroenterology PastSince Jan 17, 2006 Accepting new patients

Locations

8767 Wilshire Blvd
#2
Beverly Hills, CA 90211

8767 Wilshire Blvd
Fl 2
Beverly Hills, CA 90211
Phone (310) 248-7000

12400 Wilshire Blvd
Ste 100
Los Angeles, CA 90025
Phone (310) 422-5566

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

1919 Santa Monica Blvd
Ste 200
Santa Monica, CA 90404
Phone (310) 453-1871

2001 Santa Monica Blvd
Ste 360W
Santa Monica, CA 90404
Phone (310) 453-1871

2001 Santa Monica Blvd
Ste 360
Santa Monica, CA 90404
Phone (310) 453-1871

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mwishingrad204193@direct.cshs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1093764359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "SUITE 360W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-453-1871",
            "fax_number": "310-453-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "SUITE 360W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-453-1871",
            "fax_number": "310-453-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHINGRAD",
        "first_name": "MARC",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G69602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G696020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.