NPIMap

Individual provider Active NPI

Vlad Nusinovich, M.D.

  • Internal Medicine Physician
  • West Hollywood, CA
National Provider Identifier
1144288036
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A92996 Issued in CA
Practice address
7855 Santa Monica Blvd
West Hollywood, CA 90046-5344
Phone
(310) 623-9222
Fax
(310) 921-5623
NPI assigned
May 2, 2006
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A92996 CA Primary

Addresses

Primary practice location

7855 Santa Monica Blvd
West Hollywood, CA 90046-5344

Mailing address

7855 Santa Monica Blvd
West Hollywood, CA 90046-5344
Phone (310) 623-9222

Other identifiers 1

IdentifierTypeStateIssuer
A92996OtherCAMEDICARE PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080124000182 CA Practitioner - Internal MedicinePractitioner - General Practice 4981607736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7855 Santa Monica Blvd
West Hollywood, CA 90046-5344
Phone (310) 623-9222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A92996CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L.E.V. Medical Group, a Professional Medical Corporation Internal Medicine CurrentSince Jun 1, 2008 Accepting new patients
David Mazer,M.D.,P.a. Past Accepting new patients
Mednik Medical Corporation Past Accepting new patients
Val Shulman M D Inc PastSince May 1, 2003 Accepting new patients
Maximum Palliative Care and Hospice, Inc. PastSince Jul 24, 2018 Accepting new patients
Ca Best Diagnostics, Inc. Past Accepting new patients

Locations

7855 Santa Monica Blvd
West Hollywood, CA 90046
Phone (310) 623-9222

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Affinity Home Health, Inc.Culver City, CA, CCN 059202 Home health agency Contracted Managing Employee Jun 17, 2009
Maximum Palliative Care and Hospice, Inc.Lancaster, CA, CCN B21523 Hospice 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
W-2 Managing Employee (50%)		 Jul 24, 2018
Jul 24, 2018
Jul 24, 2018
Jul 24, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1144288036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465344",
            "telephone_number": "310-623-9222",
            "fax_number": "310-921-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465344",
            "telephone_number": "310-623-9222",
            "fax_number": "310-921-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSINOVICH",
        "first_name": "VLAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A92996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "A92996",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.