Individual provider Active NPI

H. Michael Mynatt, MD

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1326100207
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G28022 Issued in CA
Practice address
1300 N Vermont Ave
Doctors Tower -- Suite 100
Los Angeles, CA 90027-6061
Phone
(323) 913-4300
Fax
(323) 931-4301
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G28022 CA Primary

Addresses

Primary practice location

1300 N Vermont Ave
Doctors Tower -- Suite 100
Los Angeles, CA 90027-6061

Mailing address

157 S Windsor Blvd
Los Angeles, CA 90004-3817
Phone (323) 660-7575

Other identifiers 2

IdentifierTypeStateIssuer
1326100207MedicaidCA
00G280220MedicaidCA

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
I20081201000116 CA Practitioner - Orthopedic Surgery 0446267181 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G28022CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
H Michael Mynatt M D Inc Orthopaedic Surgery CurrentSince Jan 1, 1998 Accepting new patients
Lawrence D. Dorr, M.D., Inc. Past Accepting new patients
California Orthopedics and Sports Medicine Associates Orthopaedic Surgery Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

17525 Ventura Blvd
Ste 210
Encino, CA 91316
Phone (818) 501-8743

1300 N Vermont Ave
Ste 407
Los Angeles, CA 90027
Phone (323) 627-4874

2200 W 3rd St
Ste 400
Los Angeles, CA 90057
Phone (213) 484-7600

1300 N Vermont Ave
Ste 100
Los Angeles, CA 90027
Phone (323) 913-4300

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1326100207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 S WINDSOR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043817",
            "telephone_number": "323-660-7575",
            "fax_number": "818-638-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "address_2": "DOCTORS TOWER -- SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276061",
            "telephone_number": "323-913-4300",
            "fax_number": "323-931-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYNATT",
        "first_name": "H. MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G28022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326100207",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G280220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.