Active NPI
Luba Medvedev, DC
- Chiropractor
- San Mateo, CA
National Provider Identifier
1205901535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC26445
- Practice address
- 1 Baywood Ave Ste 4
San Mateo, CA 94402-1537 - Phone
- (650) 343-8512
- Fax
- (408) 725-0172
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC26445 | CA | Primary |
Addresses
Primary practice location
1 Baywood Ave Ste 4
San Mateo, CA 94402-1537
Mailing address
4927 Englewood Dr
San Jose, CA 95129-4232
Phone (408) 725-2691
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0264451 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC26445 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dina Sverdlov MD a Professional Corporation | Past | Accepting new patients | |
| Palo Alto Medical Foundation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- San Mateo, CA
- NPI 1790846657
-
- Non-Pharmacy Dispensing Site
- Santa Cruz, CA
- NPI 1114182649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205901535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4927 ENGLEWOOD DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951294232",
"telephone_number": "408-725-2691",
"fax_number": "408-725-0172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BAYWOOD AVE STE 4",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944021537",
"telephone_number": "650-343-8512",
"fax_number": "408-725-0172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDVEDEV",
"first_name": "LUBA",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC26445",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DC0264451",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.