Individual provider Active NPI

Mikhail Vizel, MD

  • Internal Medicine Physician
  • Sherman Oaks, CA
National Provider Identifier
1366477333
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A53626 Issued in CA
Practice address
5000 Van Nuys Blvd Ste 200
Sherman Oaks, CA 91403-1717
Phone
(818) 716-2100
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A53626 CA Primary

Addresses

Primary practice location

5000 Van Nuys Blvd Ste 200
Sherman Oaks, CA 91403-1717

Mailing address

13790 Hightop St
Moorpark, CA 93021-5053
Phone (818) 580-2364

Other identifiers 1

IdentifierTypeStateIssuer
0A536260MedicaidCA

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
I20041022000991 CA Practitioner - Internal Medicine 7517928526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Moorpark, CA 93021
Phone (619) 382-0438

4849 Van Nuys Blvd
Suite 202
Sherman Oaks, CA 91403-2110
Phone (818) 580-2364

Hospital & facility affiliations

  • XL Care, Inc Home health agency, Woodland Hills, CA, CCN 058236

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53626CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mikhail Vizel, MD, Medical Corporation Internal Medicine CurrentSince Oct 6, 2004 Accepting new patients
Greater Los Angeles Oncology Medical Corporation Past Accepting new patients

Locations

4849 Van Nuys Blvd
Ste 202
Sherman Oaks, CA 91403
Phone (818) 784-5300

5000 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403
Phone (818) 580-2285

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.

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1366477333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13790 HIGHTOP ST",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930215053",
            "telephone_number": "818-580-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 VAN NUYS BLVD STE 200",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031717",
            "telephone_number": "818-716-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZEL",
        "first_name": "MIKHAIL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A53626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A536260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.