Ivy Medical Associates Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A86275 Issued in CA

Legal business name

IVY MEDICAL ASSOCIATES INC

Practice address

2309 Paloma St
Pasadena, CA 91104-4926

Phone

(626) 808-5352

NPI assigned

Jan 11, 2012

Organization subpart

No

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

Authorized official

Name

Charise L Ivy, M.D.NPI 1871668293

Title

Ceo/President

Phone

(626) 808-5352

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Charise Leanne Ivy, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Glendale, CA
  • NPI 1871668293
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1306116041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 PALOMA ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911044926",
            "telephone_number": "626-808-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 PALOMA ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911044926",
            "telephone_number": "626-808-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "IVY",
        "authorized_official_first_name": "CHARISE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "626-808-5352",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A86275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Itano Dentistry
• Alan S K Itano, DDS
• Caitlin Ito, MA, OTR/L
• Ashley Marie Nevin Itzhakian, PH.D.
• Dakota Iverson
• Paul Hiromi Iwahashi, RN
• Carly Iwasa, LAC.
• Shunpei Keith Iwata, M.D.
• Ixir Health
• Silvia Ixtepan

• Physical Medicine & Rehabilitation Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

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

Verify at the official NPI Registry.