Individual provider Active NPI

Jeffrey Michael Egler, M.D.

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1366420523
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A87469 Issued in CA
Practice address
2811 Wilshire Blvd
Suite 610
Santa Monica, CA 90403-4803
Phone
(310) 453-2335
Fax
(214) 393-4645
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A87469 CA Primary

Addresses

Primary practice location

2811 Wilshire Blvd
Suite 610
Santa Monica, CA 90403-4803

Mailing address

2811 Wilshire Blvd
Suite 610
Santa Monica, CA 90403-4803
Phone (310) 453-2335

Other identifiers 3

IdentifierTypeStateIssuer
100509001MedicaidNV
00A874690MedicaidCA
100509000MedicaidNV

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
I20060801000261 CA Practitioner - Endocrinology 1153234919 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87469CAMDPharmacist
A87469CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Emergency Physicians Inc CurrentSince Jan 1, 2011 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2010 Accepting new patients
Usc Care Medical Group, Inc Family Medicine CurrentSince Apr 1, 2010 Accepting new patients
Inpatient Consultants of Colorado PC Family Medicine Past Accepting new patients
Inpatient Consultants of Colorado, PC Family Medicine Past Accepting new patients

Locations

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

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1366420523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 610",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-453-2335",
            "fax_number": "214-393-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 610",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-453-2335",
            "fax_number": "214-393-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGLER",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A87469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100509001",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A874690",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100509000",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.