Individual provider Active NPI

Fiona Baerveldt Wertheimer, D.O.

  • Neonatal-Perinatal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1174672885
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
2OA10827 Issued in CA
Practice address
2020 Zonal Ave
Ird 820
Los Angeles, CA 90033-1019
Phone
(323) 226-3406
Fax
(323) 226-3440
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A10827 CA
Pediatrics Physician 208000000X OS10427 FL
Neonatal-Perinatal Medicine Physician 2080N0001X 2OA10827 CA Primary

Addresses

Primary practice location

2020 Zonal Ave
Ird 820
Los Angeles, CA 90033-1019

Mailing address

2020 Zonal Ave
Ird 820
Los Angeles, CA 90033-1019
Phone (323) 226-3406

Other identifiers 1

IdentifierTypeStateIssuer
0001049-00MedicaidFL

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
I20220926001631 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4981768439

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS10427FLMDPediatrics Physician
2OA10827CAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of California, a Professional Corporation Pediatrics Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1174672885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 ZONAL AVE",
            "address_2": "IRD 820",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331019",
            "telephone_number": "323-226-3406",
            "fax_number": "323-226-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 ZONAL AVE",
            "address_2": "IRD 820",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331019",
            "telephone_number": "323-226-3406",
            "fax_number": "323-226-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTHEIMER",
        "first_name": "FIONA",
        "middle_name": "BAERVELDT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A10827",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS10427",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "2OA10827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001049-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.