Individual provider Active NPI

Anita Mathoni, MD

  • Pediatric Anesthesiology Physician
  • West Hollywood, CA
National Provider Identifier
1366440885
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
G78206 Issued in CA
Practice address
8700 Beverly Blvd
Suite 8211
West Hollywood, CA 90048-1804
Phone
(213) 637-3703
Fax
(213) 639-0797
NPI assigned
Jul 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G78206 CA
Pediatric Anesthesiology Physician 207LP3000X G78206 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
Suite 8211
West Hollywood, CA 90048-1804

Mailing address

3530 Wilshire Blvd
Suite 350
Los Angeles, CA 90010-2328
Phone (213) 637-3703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20220715000124 NH Practitioner - Anesthesiology 6709066483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Anesthesia Associates of New England PCGroup PAC ID 8921340886, 14 clinicians

Practice addresses (Care Compare)

1 Parkland Dr
Derry, NH 03038-2746
Phone (603) 432-1500

Hospital & facility affiliations

  • Parkland Medical Center Hospital, Derry, NH, CCN 300017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G78206CAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of New England PC Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1366440885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 WILSHIRE BLVD",
            "address_2": "SUITE 350",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102328",
            "telephone_number": "213-637-3703",
            "fax_number": "213-639-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "address_2": "SUITE 8211",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "213-637-3703",
            "fax_number": "213-639-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHONI",
        "first_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G78206",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "G78206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.