Individual provider Active NPI

Paul J. Brody, D.P.M.

  • Podiatrist
  • Culver City, CA
National Provider Identifier
1376578351
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2963 Issued in CA
Practice address
3831 Hughes Ave Ste 700
Culver City, CA 90232
Phone
(310) 837-3668
Fax
(310) 837-3015
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 2031 NV
Foot Surgery Podiatrist 213ES0131X E2963 CA
Podiatrist 213E00000X E2963 CA Primary

Addresses

Primary practice location

3831 Hughes Ave Ste 700
Culver City, CA 90232

Mailing address

3831 Hughes Ave Ste 700
Culver City, CA 90232-2751
Phone (310) 837-3668

Other practice location 1

9080 W Post Rd
Las Vegas, NV 89148-2419
Phone (702) 620-3103

Other identifiers 2

IdentifierTypeStateIssuer
E2963OtherCASTATE LICENSE NUMBER
2031OtherNVSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2031NVMDAcupuncturist
E2963CAMDFoot Surgery Podiatrist

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": "1531785600000",
    "number": "1376578351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 700",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-837-3668",
            "fax_number": "310-837-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 700",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90232",
            "telephone_number": "310-837-3668",
            "fax_number": "310-837-3015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9080 W Post Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891482419",
            "country_code": "US",
            "telephone_number": "702-620-3103",
            "fax_number": "310-837-3015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODY",
        "first_name": "PAUL",
        "middle_name": "J.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NV",
            "license": "2031",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E2963",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "E2963",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "2031",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.