Individual provider Active NPI

Roberto Travieso, M.D.

  • Plastic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1255779658
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A162038 Issued in CA
Practice address
1450 San Pablo St Ste 6200
Los Angeles, CA 90033-5331
Phone
(323) 442-7920
NPI assigned
Jun 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A162038 CA Primary

Addresses

Primary practice location

1450 San Pablo St Ste 6200
Los Angeles, CA 90033-5331

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-7920

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address roberto.travieso@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
I20210816003728 CA Practitioner - Plastic and Reconstructive Surgery 5799084802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Duke University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582

1450 San Pablo St
Los Angeles, CA 90033-4500

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

Hospital & facility affiliations

  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A162038CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2021 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2021 Accepting new patients

Locations

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

1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

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

1510 San Pablo St
Ste 415
Los Angeles, CA 90033
Phone (323) 442-5843

Interoperability endpoints

  • Direct secure messaging: rtravieso719491@direct.hopkinsmedicine.org
  • Direct secure messaging: rtravieso52411@cityofhope.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1255779658",
    "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": "323-442-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST STE 6200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335331",
            "telephone_number": "323-442-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIESO",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A162038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roberto.travieso@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1450 San Pablo St Ste 6200",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335331",
            "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.