Individual provider Active NPI

Ellen Lorange, D.O

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1164644357
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A14389 Issued in CA
Practice address
4900 W Sunset Blvd
Los Angeles, CA 90027-5814
Phone
(323) 783-4812
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X LT11639 ND
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 20A14389 CA Primary
Obstetrics & Gynecology Physician 207V00000X 036.129633 IL

Addresses

Primary practice location

4900 W Sunset Blvd
Los Angeles, CA 90027-5814

Mailing address

4900 W Sunset Blvd
Los Angeles, CA 90027-5814
Phone (323) 783-4812

Electronic endpoints 1

TypeEndpointUseAffiliation
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

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
I20160202002659 CA Practitioner - Obstetrics/Gynecology 3971628991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011

4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784

4900 W Sunset Blvd
Los Angeles, CA 90027-5814
Phone (323) 783-4011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14389CAMDObstetrics & Gynecology Physician
036.129633ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 4, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 4, 2016 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Asian Pacific Health Care Venture, Inc. CurrentSince Aug 18, 2018 Accepting new patients
Asian Pacific Health Care Venture, Inc. CurrentSince Aug 18, 2018 Accepting new patients

Locations

9960 Baldwin Pl
El Monte, CA 91731
Phone (626) 774-2988

180 Union Pl
Los Angeles, CA 90026
Phone (323) 644-3880

4900 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-4014

4216 Fountain Ave
Los Angeles, CA 90029
Phone (323) 644-3880

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

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1164644357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275814",
            "telephone_number": "323-783-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275814",
            "telephone_number": "323-783-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORANGE",
        "first_name": "ELLEN",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "LT11639",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A14389",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.129633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.