Body of Beverly Hills Wellness Inc

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

BODY OF BEVERLY HILLS WELLNESS INC

Practice address

17609 Ventura Blvd Ste 104
Encino, CA 91316-5148

Phone

(818) 291-3636

Fax

(877) 395-9650

NPI assigned

Nov 7, 2023

Organization subpart

No

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

Authorized official

Name

Heidi Regenass, MDNPI 1225258965

Title

Ceo

Phone

(818) 291-3636

Specialties & licenses 2

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heidi Regenass, M.D.

  • Plastic Surgery Physician
  • Santa Ana, CA
  • NPI 1225258965

  Multi-Specialty

  NPD Authorized official
• Mike Galstyan, DC

  • Chiropractor
  • Encino, CA
  • NPI 1013634229
  NPD
• Matthew Mai

  • Chiropractor
  • Encino, CA
  • NPI 1013840743
  NPD (past)

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1275307662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17609 VENTURA BLVD STE 104",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165148",
            "telephone_number": "818-291-3636",
            "fax_number": "877-395-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17609 VENTURA BLVD STE 104",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165148",
            "telephone_number": "818-291-3636",
            "fax_number": "877-395-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY OF BEVERLY HILLS WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "REGENASS",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-291-3636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blythe Project LLC
• Lauren Renee Boasberg, LMFT
• Marina Bochkur-Dratver, PSY.D.
• Body Dynamix Chiropractic and Performance
• Body Medical Wellness Inc
• Bodylogicmd of Encino P.C.
• Melonie Adriana Bojorquez
• Jemma Jasmin Bolaoen, OTR/L
• Heather Marie Bonawitz
• Emma G. Boncaras, MFC

• All providers in Encino, CA
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.