Individual provider Active NPI

Michael J. Albertson, M.D.

  • Gastroenterology Physician
  • Thousand Oaks, CA
National Provider Identifier
1114035128
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G22904 Issued in CA
Practice address
100 Moody CT Ste 200
Thousand Oaks, CA 91360-6082
Phone
(805) 418-3500
Fax
(805) 418-3505
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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 G22904 CA Primary

Addresses

Primary practice location

100 Moody CT Ste 200
Thousand Oaks, CA 91360-6082

Mailing address

5767 W Century Blvd # 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
00G229040MedicaidCA

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
I20060929000298 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 2163470832 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Un of California, Irvine, College of Medicine, 1971
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8631 W 3Rd St
Suite 620
Los Angeles, CA 90048-5910
Phone (310) 657-9841

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Associates, a Medical Group, Inc. Gastroenterology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: malbertson188814@direct.uclahealth.org

Organizations & group practices 1

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 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1114035128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD # 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MOODY CT STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606082",
            "telephone_number": "805-418-3500",
            "fax_number": "805-418-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERTSON",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G22904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G229040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.