Individual provider Active NPI

Alden Bunyan, PA-C

  • Medical Physician Assistant
  • Beverly Hills, CA
National Provider Identifier
1265175574
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
60940 Issued in CA
Practice address
8750 Wilshire Blvd Ste 350
Beverly Hills, CA 90211-2700
Phone
(310) 652-0010
NPI assigned
Apr 14, 2022
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1176665 CA
Medical Physician Assistant 363AM0700X 60940 CA Primary

Addresses

Primary practice location

8750 Wilshire Blvd Ste 350
Beverly Hills, CA 90211-2700

Mailing address

8750 Wilshire Blvd Ste 350
Beverly Hills, CA 90211-2700
Phone (310) 652-0010

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230105001184 CA Practitioner - Physician Assistant 9931579067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
R.S. Venuturupalli, M.D. IncGroup PAC ID 5991712739, 7 clinicians

Practice addresses (Care Compare)

8750 Wilshire Blvd
Suite 350
Beverly Hills, CA 90211-2700
Phone 3106520010120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.08 of 100Reported as group
Quality
86.07
Promoting interoperability
100
Improvement activities
40
Cost
47.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1176665CAMDPhysician Assistant
60940CAMDMedical Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1265175574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8750 WILSHIRE BLVD STE 350",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112700",
            "telephone_number": "310-652-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8750 WILSHIRE BLVD STE 350",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112700",
            "telephone_number": "310-652-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNYAN",
        "first_name": "ALDEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-14",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1176665",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "60940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.