Alessandro A Avila, MD
Individual provider Active NPI Family Medicine Physician · Mission Hills, CA
NPI 1114523958 · NPPES record last updated Jul 24, 2024
Key facts
- NPI
- 1114523958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A194887 (CA)
- Practice address
- 11333 Sepulveda Blvd
Mission Hills, CA 91345-1116 - Phone
- (818) 869-7267
- NPI assigned
- Dec 8, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- San Juan Bautista School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Providence Facey Medical Foundation
Practice addresses (Care Compare)
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531
19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400
2655 1St St
Suite 325
Simi Valley, CA 93065-1581
Phone (805) 206-2000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WY, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240227004480 | WY | Practitioner - Emergency Medicine |
9436528445 | Reassigns benefits to 2 organizations |
| I20240719001731 | CA | Practitioner - Family Practice | 9436528445 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A194887 | CA | MD | Family Medicine Physician |
| 192-T1 | WY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospital | Family Medicine | Current | Accepting new patients |
| Providence Facey Medical Foundation | Current |
Accepting new patients | |
| Providence Facey Medical Foundation | Family Medicine | Current |
Accepting new patients |
| Platte County Hospital | Current | Accepting new patients |
Locations
File 50670
Los Angeles, CA 90074
11333 Sepulveda Blvd
Mission Hills, CA 91345
Phone (818) 365-9531
18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600
19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400
2000 Campbell Dr
Torrington, WY 82240
Phone (307) 532-4181
201 14th St
Wheatland, WY 82201
Phone (307) 322-3636
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 192-T1 | WY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | A194887 | CA | Yes |
Addresses
Primary practice location
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Mailing address
PO Box 960
Mission Hills, CA 91346-9602
Phone (818) 837-5559
Other providers in Mission Hills, CA
- Josef Astor
- Brian Patrick Austin
- Harry Avellona
- Avenue Drug & Alcohol Treatment Center
- Christine Elise Averill
- Sofia Avitia
- Veronica Nicole Ayala
- Benjamin Azaran
- Ali Azizi
- Bushra K Azom
All providers in Mission Hills, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.