Michael Holmes Secrist, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

A149495 Issued in CA

Practice address

3751 Katella Ave
Los Alamitos, CA 90720-3113

Phone

(562) 598-1311

Fax

(562) 598-0355

NPI assigned

Jun 28, 2012

Last updated

Nov 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Diagnostic Radiology

Education

Medical College of Wisconsin, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

UC RegentsGroup PAC ID 3274446182, 105 clinicians

Sol Radiology IncGroup PAC ID 1850796681, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
• Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
• San Gorgonio Memorial Hospital Hospital, Banning, CA, CCN 050054
• Mad River Community Hospital Hospital, Arcata, CA, CCN 050028
• Victor Valley Global Medical Center Hospital, Victorville, CA, CCN 050517

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sol Radiology, Inc.

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1457928111

  Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD
• UC Regents

  dba UCI Radiology Associates

  • Diagnostic Radiology Physician
  • Orange, CA
  • NPI 1346298528
  Medicare reassignment Care Compare group NPD
• Los Alamitos Radiology Group Inc

  • Diagnostic Radiology Physician
  • Los Alamitos, CA
  • NPI 1427005024
  Medicare reassignment NPD
• Golden State Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1144872052

  CA, Vascular & Interventional Radiology

  Medicare reassignment NPD
• Krishna Das MD Inc.

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1164284196
  Medicare reassignment
• Los Alamitos Radiology Group Inc

  • Diagnostic Radiology Physician
  • Burbank, CA
  • NPI 1972080356
  NPD
• UC Regents

  dba Uci Health-Fountain Valley Imaging-Warner Ave

  • Diagnostic Radiology Physician
  • Fountain Valley, CA
  • NPI 1902177785
  NPD
• UC Irvine Health- Newport Doctors Medical Group- Radiology

  • Medical Specialty Clinic/Center
  • Newport Beach, CA
  • NPI 1255796157
  NPD (past)

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

• American Hospital Management Corporation

  dba Mad River Community Hospital

  • General Acute Care Hospital
  • Arcata, CA
  • NPI 1518996040
  Care Compare affiliation
• Desert Valley Hospital, LLC

  dba Desert Valley Hospital

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  Care Compare affiliation
• Prime Healthcare Services - Shasta LLC

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1205089026
  Care Compare affiliation
• San Gorgonio Memorial Hospital

  • General Acute Care Hospital
  • Banning, CA
  • NPI 1568469997
  Care Compare affiliation
• Victor Valley Hospital Acquisition, Inc.

  dba Victor Valley Global Medical Center

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1679879589
  Care Compare affiliation

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1184988669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203113",
            "telephone_number": "562-598-1311",
            "fax_number": "562-598-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203113",
            "telephone_number": "562-598-1311",
            "fax_number": "562-598-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECRIST",
        "first_name": "MICHAEL",
        "middle_name": "HOLMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A149495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Schrock, LMFT
• Rebecca J Schwartz, MD
• Script Infusion Pharmacy, Inc.
• Seaview Enterprises LLC (MedisourceRX)
• Perry Robert Secor, MD
• Stephanie Segovia, M.A., AMFT
• Ellen Marlene Sehlmeyer, P.T. , MFT
• Candia Gay Seibly, OTR/L
• Mary Seiersen, RDE
• Michaelle Seiter, LCSW

• Vascular & Interventional Radiology Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Vascular & Interventional Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.