Douglas Louis Prisco, MD.
Individual provider Active NPI Pulmonary Disease Physician · Mission Hills, CA
NPI 1154537058 · NPPES record last updated May 15, 2026
Key facts
- NPI
- 1154537058
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- A108810 (CA)
- Practice address
- 11333 Sepulveda Blvd
Mission Hills, CA 91345-1116 - Phone
- (818) 365-9531
- NPI assigned
- May 15, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Providence Facey Medical Foundation
Practice addresses (Care Compare)
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531
14550 Soledad Canyon Rd
Canyon Country, CA 91387-2200
Phone (661) 250-5200
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
Hospital & facility affiliations
- Providence Holy Cross Medical Center
- Henry Mayo Newhall Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20091005000396 | CA | Practitioner - Pulmonary Disease |
6305982364 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236893 | NY | MD | Critical Care Medicine (Internal Medicine) Physician |
| A108810 | CA | MD | Pulmonary Disease Physician |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Facey Medical Foundation | Current |
Accepting new patients | |
| Providence Facey Medical Foundation | Internal Medicine | Current |
Accepting new patients |
| Providence Facey Medical Foundation | Past | Accepting new patients | |
| Henry Mayo Newhall Memorial Hospital | Past | Accepting new patients | |
| Banks-Jackson-Commerce Hospital and Nursing Home Authority | Past | Accepting new patients | |
| Providence Health System - Southern California | Past | Accepting new patients |
Locations
File 50670
Los Angeles, CA 90074
11333 Sepulveda Blvd
Fl 3
Mission Hills, CA 91345
Phone (818) 869-7268
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
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- dprisco350544@oc.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | A108810 | CA | |
| Pulmonary Disease Physician | 207RP1001X | A108810 | CA | Yes |
| Pulmonary Disease Physician | 207RP1001X | 236893 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | A108810 | CA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 236893 | NY | |
| Internal Medicine Physician | 207R00000X | A108810 | CA |
Addresses
Primary practice location
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Mailing address
PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5691
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A1088100 | Medicaid | CA | |
| GR0100430 | Other | CA | GROUP MEDICAL |
| 1902846306 | Other | CA | GROUP NPI |
| W18762 | Other | CA | GROUP MEDICARE |
Other providers in Mission Hills, CA
- Michael Leslee Potruch
- Allen S. Pourmoussa
- Andrew M Pourmoussa
- Pregnancy Counseling Center
- Priority Home Health Care, Inc.
- Pro-Service Home Health
- Professional Imaging Medical Group
- Professional Nurses Home Care Inc
- Prohealth Medical Group, Inc
- Prohealth-Valley Occupational Medical Group
All providers in Mission Hills, CA · Pulmonary Disease 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 May 15, 2026. 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.