Organization Active NPI

Robert Huizenga MD a Medical Corporation

  • Internal Medicine Physician
  • Beverly Hills, CA
National Provider Identifier
1235243908
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G40228 Issued in CA
Legal business name
ROBERT HUIZENGA MD A MEDICAL CORPORATION
Practice address
150 N Robertson Blvd
Suite 115
Beverly Hills, CA 90211-2142
Phone
(310) 657-9191
Fax
(310) 657-9088
NPI assigned
Aug 18, 2006
Last updated
Aug 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Authorized official

Name
Robert John Huizenga, M.D.NPI 1245264720
Title
Owner
Phone
(310) 657-9191

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G40228 CA Primary

Addresses

Primary practice location

150 N Robertson Blvd
Suite 115
Beverly Hills, CA 90211-2142

Mailing address

150 N Robertson Blvd
Suite 115
Beverly Hills, CA 90211-2142
Phone (310) 657-9191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061030000443 CA Part B Supplier - Clinic/Group Practice 8729085022 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1235243908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N ROBERTSON BLVD",
            "address_2": "SUITE 115",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112142",
            "telephone_number": "310-657-9191",
            "fax_number": "310-657-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N ROBERTSON BLVD",
            "address_2": "SUITE 115",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112142",
            "telephone_number": "310-657-9191",
            "fax_number": "310-657-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT HUIZENGA MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "HUIZENGA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-657-9191",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G40228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.