Active NPI
Brandon Mark Wiley, M.D.
- Cardiovascular Disease Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- A116066
- Practice address
- 1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312 - Phone
- (323) 442-5100
- NPI assigned
- Oct 20, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A116066 | CA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | A116066 | CA | |
| Cardiovascular Disease Physician | 207RC0000X | A116066 | CA | Primary |
Addresses
Primary practice location
1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Temple University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582
1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444
1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273
1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273
1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
1520 San Pablo St
Ste 1000
Los Angeles, CA 90033
Phone (626) 457-5839
800 E 28th St
Ste H2100
Minneapolis, MN 55407
Phone (612) 863-3900
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
424 W State Highway 5
Waconia, MN 55387
Phone (952) 442-4461
Organizations & group practices 13
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.
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
Internal Medicine
-
- Cardiovascular Disease Physician
- Waconia, MN
- NPI 1871780478
Internal Medicine
-
dba Fair Oaks Clinic
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
-
- General Acute Care Hospital
- Fairmont, MN
- NPI 1821066499
-
- Critical Access Hospital
- Lake City, MN
- NPI 1538113022
-
dba Mayo Clinic Health System-Cannon Falls
- Critical Access Hospital
- Cannon Falls, MN
- NPI 1063435410
-
dba Mayo Clinic Health System-Red Wing
- General Acute Care Hospital
- Red Wing, MN
- NPI 1164400024
-
dba Mayo Clinic Health System-Albert Lea and Austin
- General Acute Care Hospital
- Albert Lea, MN
- NPI 1346258100
-
dba Mayo Clinic Health System-New Prague
- Critical Access Hospital
- New Prague, MN
- NPI 1124035282
-
dba Mayo Clinic Health System - Mankato
- General Acute Care Hospital
- Mankato, MN
- NPI 1154302487
-
dba Mayo Clinic Health System-Waseca
- Critical Access Hospital
- Waseca, MN
- NPI 1740256668
-
- Critical Access Hospital
- Saint James, MN
- NPI 1639198732
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Los Angeles General Medical Center
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1598773715
-
dba Keck Hospital of USC
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1013514199
-
dba USC Kenneth Norris Jr. Hospital
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1417554528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1104152412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "323-442-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SAN PABLO ST STE 1000",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335312",
"telephone_number": "323-442-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "BRANDON",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-20",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A116066",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "CA",
"license": "A116066",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "A116066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.