Individual provider Active NPI

Michael Zdzislaw Kasperkiewicz

  • Dermatology Physician
  • Los Angeles, CA
National Provider Identifier
1265099097
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A184360 Issued in CA
Practice address
10250 Santa Monica Blvd Ste 2440
Los Angeles, CA 90067-6593
Phone
(310) 286-0122
NPI assigned
May 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X F590 CA
Dermatology Physician 207N00000X A184360 CA Primary

Addresses

Primary practice location

10250 Santa Monica Blvd Ste 2440
Los Angeles, CA 90067-6593

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

1450 San Pablo St Ste 2000
Los Angeles, CA 90033-5331
Phone (323) 442-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.kasperkiewicz@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
I20190625002334 CA Practitioner - Dermatology 8022342013 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 8426956160, 33 clinicians
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

100 Medical Plaza
Suite 216
Los Angeles, CA 90095-0001
Phone (310) 206-8662

200 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 825-6911

2001 Santa Monica Blvd
Suite 1070
Santa Monica, CA 90404-2202
Phone (310) 917-3376

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

2020 Santa Monica Blvd
Suite 510
Santa Monica, CA 90404-2131
Phone (310) 582-6360

2780 Skypark Dr
Suite 125
Torrance, CA 90505-7528
Phone (310) 530-8001

Hospital & facility affiliations

  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions389
Removal or shaving of skin growth14
Skin biopsy52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A184360CAMDDermatology Physician
F590CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Oct 1, 2024 Accepting new patients
The Regents of the University of California Dermatology CurrentSince Oct 1, 2024 Accepting new patients
The Regents of the University of California CurrentSince Oct 1, 2024 Accepting new patients
UCLA Medical Group Dermatology Past Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

10250 Santa Monica Blvd
Ste 2440
Los Angeles, CA 90067
Phone (310) 286-0122

200 Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

File 55737
Los Angeles, CA 90074

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

892 Aerovista Pl
Ste 240
San Luis Obispo, CA 93401
Phone (805) 541-8252

2001 Santa Monica Blvd
Ste 1070
Santa Monica, CA 90404
Phone (310) 315-7900

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

2001 Santa Monica Blvd
Ste 1090
Santa Monica, CA 90404
Phone (310) 582-7474

2020 Santa Monica Blvd
Ste 510
Santa Monica, CA 90404
Phone (310) 633-8400

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: michael.kasperkiewicz@direct.usc.edu
  • Direct secure messaging: mkasperkiewicz1257781@direct.uclahealth.org

Organizations & group practices 5

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 2

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1265099097",
    "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",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 SANTA MONICA BLVD STE 2440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900676593",
            "telephone_number": "310-286-0122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 San Pablo St Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335331",
            "country_code": "US",
            "telephone_number": "323-442-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASPERKIEWICZ",
        "first_name": "MICHAEL",
        "middle_name": "ZDZISLAW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "F590",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A184360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.kasperkiewicz@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 2000",
            "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.