Individual provider Active NPI

Antoin Douglawi, M.D.

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1215317847
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A168501 Issued in CA
Practice address
1516 San Pablo St FL 5
Los Angeles, CA 90033-5313
Phone
(323) 865-3700
NPI assigned
Jun 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A168501 CA Primary

Addresses

Primary practice location

1516 San Pablo St FL 5
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address antoin.douglawi@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20200511001669 CA Practitioner - Urology 4880905215 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Southern California Keck School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

901 San Bernardino Rd
Suite 104And302
Upland, CA 91786-4912
Phone (909) 558-4000

File Number
Suite 54701
Los Angeles, CA 90074-4701

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245
  • Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327
  • Redlands Community Hospital Hospital, Redlands, CA, CCN 050272
  • Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292
  • Loma Linda University Medical Center-Murrieta Hospital, Murrieta, CA, CCN 050770

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168501CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Beaver Medical Group P C CurrentSince Aug 25, 2022 Accepting new patients
Sac Health System CurrentSince Sep 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2022 Accepting new patients
Beaver Medical Group P C Urology CurrentSince Aug 25, 2022 Accepting new patients
Sac Health System CurrentSince Sep 1, 2022 Accepting new patients
Usc Care Medical Group, Inc Urology CurrentSince Jun 1, 2020 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Redlands Community Hospital Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Beaver Medical Group P C Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

6109 W Ramsey St
Banning, CA 92220
Phone (909) 845-0313

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11370 Anderson St
#1100
Loma Linda, CA 92354
Phone (909) 558-2830

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1516 San Pablo St
Fl 5
Los Angeles, CA 90033
Phone (323) 276-3707

1518 San Pablo St
Ste 3500
Los Angeles, CA 90033

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: antoin.douglawi@direct.usc.edu
  • Direct secure messaging: adouglawi21093@epiclp.direct-ci.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 5

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1215317847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 SAN PABLO ST FL 5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-865-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAWI",
        "first_name": "ANTOIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A168501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "antoin.douglawi@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1516 San Pablo St Fl 5",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.