NPIMap

Individual provider Active NPI

Oleg Liakhovetski, M.D.

  • Internal Medicine Physician
  • Sherman Oaks, CA
National Provider Identifier
1154584316
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A103798 Issued in CA
Practice address
4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403-1700
Phone
(818) 528-1260
Fax
(818) 528-1261
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 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 A103798 CA Primary

Addresses

Primary practice location

4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403-1700

Mailing address

4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403-1700
Phone (818) 528-1260

Other identifiers 1

IdentifierTypeStateIssuer
A103798OtherCALISCENCE

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
I20090121000140 CA Practitioner - Internal Medicine 5395808281 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Medical Group,IncGroup PAC ID 4385883958, 54 clinicians

Practice addresses (Care Compare)

10738 Riverside Dr
Suite a
N Hollywood, CA 91602-2372
Phone (818) 505-3292

4940 Van Nuys Blvd
Suite 200
Sherman Oaks, CA 91403-1741
Phone (818) 528-1260

Hospital & facility affiliations

  • Prominent Home Care Services, Inc. Home health agency, Tujunga, CA, CCN 757592
  • Valley Home Health Care Agency, Inc Home health agency, Tarzana, CA, CCN 059049
  • Full Life Home Health, Inc. Home health agency, Panorama City, CA, CCN 757973
  • Vienna Hospice and Palliative Care, Inc Hospice, Santa Clarita, CA, CCN A01599
  • Bellerose Hospice Care Inc Hospice, Santa Clarita, CA, CCN B51653
  • Circle of Life Hospice Hospice, Burbank, CA, CCN B21642
  • Physicians Preferred Hospice Inc Hospice, Tarzana, CA, CCN A01555
  • Oliveglen Hospice Care, Inc. Hospice, Glendale, CA, CCN B51622
  • Encino Hospital Medical Center Hospital, Encino, CA, CCN 050158
  • Sherman Oaks Hospital Hospital, Sherman Oaks, CA, CCN 050755
  • Encino Hospital Medical Center Inpatient rehabilitation facility, Encino, CA, CCN 05T158
  • Tarzana Health and Rehabilitation Center Nursing home, Tarzana, CA, CCN 056124
  • Woodland Care Center Nursing home, Reseda, CA, CCN 056066
  • Lake Balboa Care Center Nursing home, Van Nuys, CA, CCN 056180
  • Grand Valley Health Care Center Nursing home, Van Nuys, CA, CCN 056363
  • Encino Hospital Medical Center D/P SNF Nursing home, Encino, CA, CCN 555380

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue210

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Truecare Medical Clinic Inc CurrentSince Oct 15, 2023 Accepting new patients
Health Lync Medical Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Harmony Wound Care Inc CurrentSince Aug 15, 2025 Accepting new patients
Alphacell Wound Care, PC CurrentSince Nov 15, 2025 Accepting new patients
Epic Medical Group,Inc Internal Medicine CurrentSince May 15, 2013 Accepting new patients
Derderyan Medical Group Inc. Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Royal Home Care, Inc PastSince Apr 30, 2003 Accepting new patients

Locations

501 W Glenoaks Blvd
Ste 26
Glendale, CA 91202

6350 Laurel Canyon Blvd
Ste 307
North Hollywood, CA 91606
Phone (424) 600-8453

25044 Peachland Ave
Ste 110
Santa Clarita, CA 91321

4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403
Phone (818) 528-1222

10738 Riverside Dr
Ste A
Toluca Lake, CA 91602
Phone (818) 505-3292

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Vienna Hospice and Palliative Care IncSanta Clarita, CA, CCN A01599 Hospice Contracted Managing Employee
Operational/Managerial Control		 Oct 23, 2019
Oct 23, 2019
Circle of Life HospiceBurbank, CA, CCN B21642 Hospice W-2 Managing Employee Aug 1, 2022
Bellerose Hospice Care IncSanta Clarita, CA, CCN B51653 Hospice Contracted Managing Employee
Operational/Managerial Control		 Oct 26, 2020
Oct 26, 2020
Care Village Hospice IncNorth Hollywood, CA, CCN D61560 Hospice W-2 Managing Employee Feb 1, 2025

Owned or controlled facilities with NPI records 4

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

Organizations & group practices 7

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1154584316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD",
            "address_2": "STE 200",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031700",
            "telephone_number": "818-528-1260",
            "fax_number": "818-528-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD",
            "address_2": "STE 200",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031700",
            "telephone_number": "818-528-1260",
            "fax_number": "818-528-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAKHOVETSKI",
        "first_name": "OLEG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A103798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE",
            "identifier": "A103798",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.