Individual provider Active NPI

Trevan Dale Fischer, M.D.

  • Surgical Oncology Physician
  • Santa Monica, CA
National Provider Identifier
1154580017
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
135300 Issued in CA
Practice address
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone
(310) 829-8781
Fax
(310) 582-7185
NPI assigned
Jun 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 135300 CA
Surgical Oncology Physician 2086X0206X 135300 CA Primary
Surgery Physician 208600000X TRN12753 FL

Addresses

Primary practice location

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Mailing address

2200 Santa Monica Blvd
Santa Monica, CA 90404-2312

Electronic endpoints 8

TypeEndpointUseAffiliation
Direct Messaging Address tfischer516712@oc.providencedirect.org
Direct Messaging Address tfischer516712@oc.providencedirect.org
Direct Messaging Address tfischer516712@oc.providencedirect.org
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group
Direct Messaging Address tfischer516712@oc.providencedirect.org
Direct Messaging Address tfischer516712@oc.providencedirect.org

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
I20170619001131 CA Practitioner - General Surgery 5496998106 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Oklahoma College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

11800 Wilshire Blvd
Los Angeles, CA 90025-6602
Phone (310) 231-2121

Hospital & facility affiliations

  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision82
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
135300CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Jul 1, 2018 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 1, 2025 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 1, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 13, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 13, 2017 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

2151 N Harbor Blvd
Ste 3100
Fullerton, CA 92835
Phone (530) 999-2533

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

11800 Wilshire Blvd
Los Angeles, CA 90025
Phone (310) 231-2121

12555 W Jefferson Blvd
#303
Los Angeles, CA 90066
Phone (424) 443-5530

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2121 Wilshire Blvd
Ste 201
Santa Monica, CA 90403
Phone (310) 264-7300

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 577-5505

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tfischer516712@oc.providencedirect.org
  • Direct secure messaging: tfischer513841@direct.cshs.org

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 7

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1154580017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "310-829-8781",
            "fax_number": "310-582-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "TREVAN",
        "middle_name": "DALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "135300",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "135300",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "TRN12753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfischer516712@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "101 E Valencia Mesa Dr",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfischer516712@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2121 Santa Monica Blvd",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfischer516712@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12555 W Jefferson Blvd # 303",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900667032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfischer516712@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2200 Santa Monica Blvd",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfischer516712@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2151 N Harbor Blvd Ste 3100",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.