Individual provider Active NPI

David B Agus, M.D.

  • Medical Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1356328249
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
G85631 Issued in CA
Practice address
12414 Exposition Blvd
Los Angeles, CA 90064-1016
Phone
(310) 272-7640
Fax
(310) 272-7656
NPI assigned
Dec 30, 2005
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G85631 CA
Medical Oncology Physician 207RX0202X G85631 CA Primary

Addresses

Primary practice location

12414 Exposition Blvd
Los Angeles, CA 90064-1016

Mailing address

12414 Exposition Blvd
Los Angeles, CA 90064-1016
Phone (310) 272-7650

Other identifiers 3

IdentifierTypeStateIssuer
W18762OtherCAGROUP MEDICARE
GR0100430OtherCAGROUP MEDICAL
1902846306OtherCAGROUP NPI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address David.agus@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC
Direct Messaging Address dagus565659@oc.providencedirect.org
Direct Messaging Address agus@eitm.org Direct

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
I20090413000335 CA Practitioner - Medical OncologyPractitioner - Internal Medicine 5698822435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12414 Exposition Blvd
Los Angeles, CA 90064-1016
Phone (310) 272-7640

2336 Santa Monica Blvd
Suite 204
Santa Monica, CA 90404-2938
Phone (310) 829-6789

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85631CAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jul 1, 2009 Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Dec 1, 2022 Accepting new patients
Providence Saint Johns Medical Foundation Specialist CurrentSince Dec 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 1, 2009 Accepting new patients
Usc Internal Medicine, Inc. Past Accepting new patients

Locations

9033 Wilshire Blvd
Ste 300
Beverly Hills, CA 90211
Phone (310) 273-0330

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dagus565659@oc.providencedirect.org
  • Direct secure messaging: david.agus@direct.usc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1356328249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12414 EXPOSITION BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641016",
            "telephone_number": "310-272-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12414 EXPOSITION BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641016",
            "telephone_number": "310-272-7640",
            "fax_number": "310-272-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUS",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G85631",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "G85631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "W18762",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAL",
            "identifier": "GR0100430",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1902846306",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "David.agus@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12414 Exposition Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900641016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dagus565659@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12414 Exposition Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900641016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agus@eitm.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12414 Exposition Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900641016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.