NPIMap

Individual provider Active NPI

Sergey Lyass, MD

  • Surgery Physician
  • Encino, CA
National Provider Identifier
1316996911
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A80181 Issued in CA
Practice address
4301 Grimes PL
Encino, CA 91316-4361
Phone
(310) 623-1786
Fax
(310) 693-5334
NPI assigned
May 9, 2006
Last updated
Oct 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A80181 CA Primary

Addresses

Primary practice location

4301 Grimes PL
Encino, CA 91316-4361

Mailing address

4301 Grimes PL
Encino, CA 91316-4361
Phone (818) 578-3388

Other identifiers 1

IdentifierTypeStateIssuer
11542441OtherCACAQH ID#

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
I20050524000844 CA Practitioner - General Surgery 6305888991 Reassigns benefits to 1 organization
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4301 Grimes PL
Encino, CA 91316-4361
Phone (310) 623-1786

5901 W Olympic Blvd
Suite 309
Los Angeles, CA 90036-4664
Phone (310) 623-1786

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Prostate resection1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80181CAMDMarriage & Family Therapist
A80181CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KLM Surgical Associates Surgery CurrentSince Nov 7, 2025 Accepting new patients
Sergey Lyass MD Surgical Surgery Current Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Dignity Community Care Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Gary Furman, M.D., Inc Surgery Past Accepting new patients
Hope Community Care Clinic, Inc PastSince Jan 1, 2025 Accepting new patients
Alexander Gershman MD Apc PastSince Nov 1, 2020 Accepting new patients

Locations

6404 Wilshire Blvd
Ste 701
Los Angeles, CA 90048
Phone (323) 852-9704

4640 Admiralty Way
Ste 901
Marina del Rey, CA 90292
Phone (310) 557-5540

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sergey.lyass@m-ca.direct.office.nextgen.com

Organizations & group practices 10

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 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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1316996911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 GRIMES PL",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164361",
            "telephone_number": "818-578-3388",
            "fax_number": "310-693-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GRIMES PL",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164361",
            "telephone_number": "310-623-1786",
            "fax_number": "310-693-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYASS",
        "first_name": "SERGEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A80181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID#",
            "identifier": "11542441",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.