Individual provider Active NPI

Brett John Sevilla, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1356393151
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A61024 Issued in CA
Practice address
520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607
Phone
(213) 252-2100
Fax
(213) 383-3146
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A61024 CA Primary

Addresses

Primary practice location

520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607

Mailing address

520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607
Phone (213) 252-2100

Other practice location 1

1635 W Main St Ste 100
Alhambra, CA 91801-1951
Phone (626) 248-1800

Other practice location 2

11050 Artesia Blvd Ste E
Cerritos, CA 90703-2542
Phone (562) 860-8838

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
I20111212000330 CA Practitioner - Psychiatry 2163697624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, San Francisco School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Special Service for Groups IncGroup PAC ID 2769396886, 61 clinicians

Practice addresses (Care Compare)

1635 W Main St
Suite 100
Alhambra, CA 91801-1951
Phone (626) 248-1800

520 S Lafayette Park PL
FL 3
Los Angeles, CA 90057-5400
Phone (213) 252-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A61024CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. CurrentSince Jul 24, 2000 Accepting new patients
Special Service for Groups, Inc. Current Accepting new patients
Special Service for Groups, Inc. CurrentSince Jul 24, 2000 Accepting new patients

Locations

1635 W Main St
Ste 100
Alhambra, CA 91801
Phone (626) 248-1800

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

Organizations & group practices 3

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1356393151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571607",
            "telephone_number": "213-252-2100",
            "fax_number": "213-383-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571607",
            "telephone_number": "213-252-2100",
            "fax_number": "213-383-3146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635 W Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918011951",
            "country_code": "US",
            "telephone_number": "626-248-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11050 Artesia Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907032542",
            "country_code": "US",
            "telephone_number": "562-860-8838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVILLA",
        "first_name": "BRETT",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A61024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.