David Alan Ditsworth, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G29004 Issued in CA

Practice address

920 S Robertson Blvd
Los Angeles, CA 90035-1612

Phone

(310) 551-0690

Fax

(310) 659-8869

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 3, 2017 through Jul 3, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Back Institute Surgery Center of Beverly Hills

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
  • NPI 1134326119
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376685420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351612",
            "telephone_number": "310-551-0690",
            "fax_number": "310-659-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351612",
            "telephone_number": "310-551-0690",
            "fax_number": "310-659-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITSWORTH",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G29004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Disque, MD
• Sumudu Nalaka Dissanayake, MD
• Charlotte Distefano, PHD
• Patricia Araceli Distefano, RN
• Margaret Gail Distler, M.D.
• Kimberly Bass Dittu, PSYD, LCSW
• Parastou Divdad
• Diversified Transportation Access, LLC
• Diversified Transportation Access, LLC
• Keith Divinagracia, PT

• Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.