Individual provider Active NPI

Brian Keith Fenmore, MD

  • Obstetrics & Gynecology Physician
  • Tarzana, CA
National Provider Identifier
1194834879
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A043642 Issued in CA
Practice address
18344 Clark St
Suite 202
Tarzana, CA 91356-3505
Phone
(818) 708-8011
Fax
(818) 708-8826
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A043642 CA Primary

Addresses

Primary practice location

18344 Clark St
Suite 202
Tarzana, CA 91356-3505

Mailing address

18344 Clark St
#202
Tarzana, CA 91356-3505
Phone (818) 708-8011

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
I20081119000901 CA Practitioner - Obstetrics/Gynecology 2668532706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18344 Clark St
Suite 202
Tarzana, CA 91356-3578
Phone (818) 708-8011

Hospital & facility affiliations

  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761
  • Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624
  • UCLA West Valley Medical Center Hospital, West Hills, CA, CCN 050481
  • Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A043642CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brian K. Fenmore, MD Inc Obstetrics & Gynecology CurrentSince Jun 12, 2012 Accepting new patients

Locations

18344 Clark St
Ste 202
Tarzana, CA 91356
Phone (562) 508-9667

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.

Hospital & facility affiliations 4

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1194834879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18344 CLARK ST",
            "address_2": "#202",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563505",
            "telephone_number": "818-708-8011",
            "fax_number": "818-708-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18344 CLARK ST",
            "address_2": "SUITE 202",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563505",
            "telephone_number": "818-708-8011",
            "fax_number": "818-708-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENMORE",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A043642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.