NPIMap

Individual provider Active NPI

Evgeny I Tsimerinov, M.D., PH.D.

  • Neurology Physician
  • Encino, CA
National Provider Identifier
1295789972
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A87842 Issued in CA
Practice address
17777 Ventura Blvd # 137
Encino, CA 91316-3736
Phone
(734) 213-9240
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A87842 CA Primary

Addresses

Primary practice location

17777 Ventura Blvd # 137
Encino, CA 91316-3736

Mailing address

17777 Ventura Blvd # 137
Encino, CA 91316-3736
Phone (734) 213-9240

Other identifiers 1

IdentifierTypeStateIssuer
A87842OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000565 CA Practitioner - Neurology 5395779037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Neuromonitoring Associates IncGroup PAC ID 1658433594, 6 clinicians

Practice addresses (Care Compare)

17777 Ventura Blvd
Suite 137
Encino, CA 91316-3738

17777 Ventura Blvd
Suite 137
Encino, CA 91316-3749
Phone (818) 305-5091

4934 Lindley Ave
Encino, CA 91316-4234
Phone (734) 213-9240

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Hoag Orthopedic Institute Hospital, Irvine, CA, CCN 050769
  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009
  • Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549
  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87842CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth Current Accepting new patients
E. Tsimerinov, MD Neurology, Inc. CurrentSince Jan 6, 2016 Accepting new patients
Pacific Neuromonitoring Associates, Inc Neurology CurrentSince Sep 1, 2016 Accepting new patients
American Neuromonitoring Associates, PC Neurology Past Accepting new patients

Locations

17777 Ventura Blvd
Ste 137
Encino, CA 91316
Phone (734) 213-9240

8700 Beverly Blvd
Ste B
West Hollywood, CA 90048

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

10275 Little Patuxent Pkwy
Ste 300
Columbia, MD 21044
Phone (734) 545-4420

Interoperability endpoints

  • Direct secure messaging: evgeny.tsimerinov.tsiev@slk.direct.slhduluth.com
  • Direct secure messaging: etsimerinov1156006@direct.hfhs.org
  • Direct secure messaging: etsimerinov103917@direct.cshs.org

Organizations & group practices 4

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 7

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1295789972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17777 VENTURA BLVD # 137",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163736",
            "telephone_number": "734-213-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17777 VENTURA BLVD # 137",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163736",
            "telephone_number": "734-213-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIMERINOV",
        "first_name": "EVGENY",
        "middle_name": "I",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A87842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A87842",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.