Individual provider Active NPI

Rosemarie Bustos Diaz

  • Emergency Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1215317441
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A171845 Issued in CA
Practice address
1250 16TH St
Santa Monica, CA 90404-1249
Phone
(310) 794-7700
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A171845 CA Primary

Addresses

Primary practice location

1250 16TH St
Santa Monica, CA 90404-1249

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

757 Westwood Plz Ste 1517
Los Angeles, CA 90095-5000
Phone (310) 825-9111

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
I20210422002079 CA Practitioner - Emergency Medicine 0244509909 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
93.25
Promoting interoperability
100
Improvement activities
40
Cost
79.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A171845CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Emer Med Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
County of Los Angeles CurrentSince Apr 2, 2021 Accepting new patients
Victory Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
County of Los Angeles CurrentSince Apr 2, 2021 Accepting new patients
UCLA Medical Group Emergency Medicine Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Westwood Plz
Ste 1517
Los Angeles, CA 90095
Phone (310) 794-0599

File 55675
Los Angeles, CA 90074

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

18300 Roscoe Blvd
Northridge, CA 91325
Phone (818) 885-5331

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Interoperability endpoints

  • Direct secure messaging: rdiaz916952@direct.uclahealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1215317441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 16TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "310-794-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz Ste 1517",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900955000",
            "country_code": "US",
            "telephone_number": "310-825-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ROSEMARIE",
        "middle_name": "BUSTOS",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A171845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.