Bert Mekpongsatorn

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4101 Issued in CA

Practice address

13012 Valleyheart Dr
1
Studio City, CA 91604-1975

Phone

(818) 674-0732

NPI assigned

May 10, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Landmark Anesthesia Medical GroupGroup PAC ID 5698055804, 19 clinicians

Anesthesia Associates of Southern California PCGroup PAC ID 5890273403, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104
• Orange County Global Medical Center Hospital, Santa Ana, CA, CCN 050746

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Landmark Anesthesia Medical Group

  • Anesthesiology Physician
  • Lynwood, CA
  • NPI 1770035024
  Medicare reassignment Care Compare group NPD
• Anesthesia Associates of Southern California PC

  • Anesthesiology Physician
  • Santa Ana, CA
  • NPI 1437013836
  Medicare reassignment Care Compare group
• St Francis Medical Center

  • Long Term Care Hospital
  • Lynwood, CA
  • NPI 1346378270
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Orange County Global Medical Center, Inc

  • General Acute Care Hospital
  • Santa Ana, CA
  • NPI 1982697678
  Care Compare affiliation
• Prime Healthcare Services - St Francis LLC

  • General Acute Care Hospital
  • Lynwood, CA
  • NPI 1114547114
  Care Compare affiliation

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1356633374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13012 VALLEYHEART DR.",
            "address_2": "1",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "91604",
            "telephone_number": "818-674-0732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13012 VALLEYHEART DR",
            "address_2": "1",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041975",
            "telephone_number": "818-674-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKPONGSATORN",
        "first_name": "BERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "710647",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "4101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce McDavitt, PHD
• Alyssa McLean, LPCC
• Medassist Home Health Services, Inc.
• Savannah Meginnis
• Michael Zakar Mekjian, PHD
• Elenita Melikterminas, DDS
• Melissa Murren, PSYD: Psychological Services, PC
• Sheyda Melkonian, PSY.D.
• Julia Burtt Meltzer, LES
• Mend & Restore LLC

• Certified Registered Nurse Anesthetist in Studio City, CA
• Providers in Studio City, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.