Individual provider Active NPI

Galen Cortina, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Van Nuys, CA
National Provider Identifier
1194753657
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G81199 Issued in CA
Practice address
15211 Vanowen St Ste 208
Van Nuys, CA 91405-3623
Phone
(818) 782-6600
NPI assigned
Jun 30, 2006
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G81199 CA Primary

Addresses

Primary practice location

15211 Vanowen St Ste 208
Van Nuys, CA 91405-3623

Mailing address

PO Box 260023
Saint Louis, MO 63126-8023
Phone (314) 849-3535

Other identifiers 1

IdentifierTypeStateIssuer
00G811990MedicaidCA

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
I20051116001083 CA Practitioner - Pathology 9335168533 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Wisconsin, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marvel Path PCGroup PAC ID 5597177485, 3 clinicians
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

15107 Vanowen St
Van Nuys, CA 91405-4542
Phone (818) 782-6600

50 Alessandro PL
Suite 440
Pasadena, CA 91105-3146
Phone (626) 808-4772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G81199CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Path MD Inc CurrentSince Feb 1, 2015 Accepting new patients
Genesis Healthcare Partners PC CurrentSince Dec 1, 2021 Accepting new patients
Skyline Urology Current Accepting new patients
Urology Institute of the South Bay Current Accepting new patients
Marvel Path PC Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2021 Accepting new patients
Northwest Pathology PLLC Anatomic Pathology & Clinical Pathology PastSince Nov 1, 2020 Accepting new patients

Locations

931 Buena Vista St
Ste 200A
Duarte, CA 91010
Phone (818) 321-2745

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

50 Alessandro Pl
Ste 440
Pasadena, CA 91105
Phone (626) 440-9190

16835 W Bernardo Dr
Ste 212
San Diego, CA 92127
Phone (858) 810-7280

18321 Ventura Blvd
Ste 150
Tarzana, CA 91356
Phone (818) 776-0660

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

15211 Vanowen St
Ste 208
Van Nuys, CA 91405
Phone (818) 343-0705

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1194753657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260023",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631268023",
            "telephone_number": "314-849-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15211 VANOWEN ST STE 208",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053623",
            "telephone_number": "818-782-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTINA",
        "first_name": "GALEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G81199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G811990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.