NPIMap

Organization Active NPI

Cse Medical Group Inc.

  • Ophthalmology Physician
  • Thousand Oaks, CA
National Provider Identifier
1215979844
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CSE MEDICAL GROUP INC.
Practice address
351 Rolling Oaks Dr Ste 102
Thousand Oaks, CA 91361-1279
Phone
(805) 497-3744
Fax
(805) 497-1663
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
Steven Corwin, M.D.NPI 1720089964
Title
President
Phone
(805) 497-3744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

351 Rolling Oaks Dr Ste 102
Thousand Oaks, CA 91361-1279

Mailing address

351 Rolling Oaks Dr
102
Thousand Oaks, CA 91361-1275
Phone (805) 497-3744

Other identifiers 1

IdentifierTypeStateIssuer
DD1437OtherCARAILROAD MEDICARE

Other names 1

  • CONEJO SIMI EYE MEDICAL GROUP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040917001119 CA Part B Supplier - Clinic/Group Practice 4082682034 Receives reassigned benefits from 8 practitioners
Practice locations: Agoura Hills, CA; Simi Valley, CA; Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

5643 Kanan Rd
Agoura Hills, CA 91301
Phone (818) 889-2020

28040 Dorothy Dr
Ste 103
Agoura Hills, CA 91301
Phone (818) 483-6334

1687 Erringer Rd
Ste 215
Simi Valley, CA 93065
Phone (805) 520-1191

351 Rolling Oaks Dr
Thousand Oaks, CA 91361
Phone (805) 373-8582

2230 Lynn Rd
Thousand Oaks, CA 91360
Phone (805) 370-3137

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1215979844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 ROLLING OAKS DR",
            "address_2": "102",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611275",
            "telephone_number": "805-497-3744",
            "fax_number": "805-497-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 ROLLING OAKS DR STE 102",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611279",
            "telephone_number": "805-497-3744",
            "fax_number": "805-497-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSE MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "CORWIN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-497-3744",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD1437",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONEJO SIMI EYE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CONEJO SIMI EYE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.