Individual provider Active NPI

Ananias E Ebilane, M.D.

  • General Practice Physician
  • Hawthorne, CA
National Provider Identifier
1265611362
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A34021 Issued in CA
Practice address
13429 S Hawthorne Blvd
Hawthorne, CA 90250-5803
Phone
(310) 644-8683
Fax
(310) 644-0132
NPI assigned
Oct 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A34021 CA Primary

Addresses

Primary practice location

13429 S Hawthorne Blvd
Hawthorne, CA 90250-5803

Mailing address

13429 S Hawthorne Blvd
Hawthorne, CA 90250-5803
Phone (310) 644-8683

Other identifiers 3

IdentifierTypeStateIssuer
1144231093OtherNPI TYPE 2
00A340210MedicaidCA
WA34021EOtherMEDICARE PTAN

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
I20080216000120 CA Practitioner - General Practice 1153404173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13429 Hawthorne Blvd
Hawthorne, CA 90250-5803
Phone (310) 644-8683

Hospital & facility affiliations

  • Comprehensive Health Care, Inc Home health agency, Los Angeles, CA, CCN 058321
  • Total Care Home Health Services Home health agency, Long Beach, CA, CCN 059113
  • Ziba Hospice LLC Hospice, Lakewood, CA, CCN 551532
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A34021CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ananias E. Ebilane, M.D., Inc General Practice CurrentSince Jan 15, 1981 Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

13429 Hawthorne Blvd
#A
Hawthorne, CA 90250
Phone (310) 644-8683

13429 Hawthorne Blvd
Hawthorne, CA 90250
Phone (310) 528-0346

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 5

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": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1265611362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13429 S HAWTHORNE BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505803",
            "telephone_number": "310-644-8683",
            "fax_number": "310-644-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13429 S HAWTHORNE BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505803",
            "telephone_number": "310-644-8683",
            "fax_number": "310-644-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBILANE",
        "first_name": "ANANIAS",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A34021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  TYPE 2",
            "identifier": "1144231093",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A340210",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WA34021E",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.