Conejo Medical and Breast Care Center a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

174400000X Issued in CA

Legal business name

CONEJO MEDICAL AND BREAST CARE CENTER A MEDICAL CORPORATION

Practice address

3180 Willow LN Ste 212
Thousand Oaks, CA 91361-4990

Phone

(805) 497-3239

Fax

(805) 497-3110

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

Michele Ghaussy, MD

Title

Coo/Practice Manager

Phone

(805) 990-4375

Specialties & licenses 4

Addresses

Other names 1

• Conejo Medical & Breast Care Center Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Conejo Med-Breast Care Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Conejo Medical & Beast Care Center

  • General Practice Physician
  • Thousand Oaks, CA
  • NPI 1922155191
  NPD tax ID

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Niloufar Guiv, M.D.

  • Specialist
  • West Hills, CA
  • NPI 1124028345

  CA

  Medicare reassignment Care Compare group
• Tami Jane Simard, DO

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1467743864

  CA

  Medicare reassignment Care Compare group
• Sima Yaftali, M.D.

  • Specialist
  • Thousand Oaks, CA
  • NPI 1629078845

  CA

  Medicare reassignment Care Compare group
• Rosemary Flores, M.D.

  • Specialist
  • Thousand Oaks, CA
  • NPI 1871593095

  CA

  Medicare reassignment
• Robert Ghaussy, M.D.

  • Specialist
  • Thousand Oaks, CA
  • NPI 1053311274

  CA

  Medicare reassignment
• Anita Susan Pakula, MD

  • Dermatology Physician
  • Westlake Village, CA
  • NPI 1205869625
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1376619262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 212",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614990",
            "telephone_number": "805-497-3239",
            "fax_number": "805-497-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 212",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614990",
            "telephone_number": "805-497-3239",
            "fax_number": "805-497-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEJO MEDICAL AND BREAST CARE CENTER A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "GHAUSSY",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "COO/PRACTICE MANAGER",
        "authorized_official_telephone_number": "805-990-4375",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "174400000X",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conejo Medical & Breast Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sean Condon, MD
• Conejo Anesthesia
• Conejo Dermatology Medical Group
• Conejo Los Robles Anesthesiology Medical Group, Inc.
• Conejo Medical & Beast Care Center
• Conejo Medical Group for Women
• Conejo Nephrology & Medical Group, Inc.
• Conejo Neurological Medical Group, Inc.
• Conejo Oaks Medical Group Inc
• Conejo Pain Specialists Medical Group Inc

• All providers in Thousand Oaks, CA
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.