Individual provider Active NPI

Spencer Leland Brown, M.D.

  • Vascular Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1124210018
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
G46653 Issued in CA
Practice address
2080 Century Park E Ste 1807
Los Angeles, CA 90067-2021
Phone
(310) 552-1077
Fax
(310) 552-0861
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X G46653 CA Primary

Addresses

Primary practice location

2080 Century Park E Ste 1807
Los Angeles, CA 90067-2021

Mailing address

6076 Bristol Pkwy Ste 108
Culver City, CA 90230-6600
Phone (310) 348-9604

Other identifiers 1

IdentifierTypeStateIssuer
00G466530MedicaidCA

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
I20100818001328 CA Practitioner - General SurgeryPractitioner - Vascular Surgery 3173657616 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Boston University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6076 Bristol Pkwy
Suite 108
Culver City, CA 90230-6600
Phone (310) 348-9604

Hospital & facility affiliations

  • Southern California Hospital at Hollywood Hospital, Hollywood, CA, CCN 050135

Merit-based Incentive Payment System (MIPS)

Final score
99.81 of 100Reported as individual
Quality
81.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Interventional Vascular Access Center Medical Corporation Vascular Surgery CurrentSince Oct 1, 2011 Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Access Care Anesthesia of California PC Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients

Locations

6076 Bristol Pkwy
Ste 108
Culver City, CA 90230
Phone (310) 248-9604

6076 Bristol Pkwy
Culver City, CA 90230
Phone (714) 510-6943

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: spencer.brown.p25@direct.aac.nextgenshare.com
  • Direct secure messaging: spencer.brown.p75@direct.aac.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1124210018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6076 BRISTOL PKWY STE 108",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306600",
            "telephone_number": "310-348-9604",
            "fax_number": "310-338-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 1807",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672021",
            "telephone_number": "310-552-1077",
            "fax_number": "310-552-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SPENCER",
        "middle_name": "LELAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G46653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G466530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.