Individual provider Active NPI

Allan J Wagman, MD

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1386626729
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G27772 Issued in CA
Practice address
1516 Cotner Ave
Los Angeles, CA 90025-3303
Phone
(310) 445-2951
Fax
(310) 479-1459
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G27772 CA Primary

Addresses

Primary practice location

1516 Cotner Ave
Los Angeles, CA 90025-3303

Mailing address

1516 Cotner Ave
Los Angeles, CA 90025-3303
Phone (310) 445-2951

Other identifiers 2

IdentifierTypeStateIssuer
00G277720MedicaidCA
GR0106039MedicaidCA

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
I20041103000704 CA Practitioner - Diagnostic Radiology 4082518907 Reassigns benefits to 15 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Maryland School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians
Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians
Fresno Imaging CenterGroup PAC ID 2466553128, 127 clinicians

Practice addresses (Care Compare)

2428 Santa Monica Blvd
Suite 100
Santa Monica, CA 90404-2046
Phone (310) 582-7900

25800 Bob Hope Dr
Suite 255
Ranco Mirage, CA 92270-1739
Phone (760) 346-6239

2601 E Tahquitz Canyon Way
Palm Springs, CA 92262-7015
Phone (760) 318-2980

3715 E S St
Long Beach, CA 90805-4521
Phone (562) 602-0700

57840 29 Palms Hwy
Yucca Valley, CA 92284-3047
Phone (760) 228-1047

6191 N Thesta St
Fresno, CA 93710-5266
Phone (559) 447-2600

72115 Hwy 111
Rancho Mirage, CA 92270-4962
Phone (760) 837-1420

72855 Fred Waring Dr
Palm Desert, CA 92260-9368
Phone (760) 837-1420

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Radiological Imaging Diagnostic Radiology CurrentSince Nov 22, 2014 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Apr 17, 2008 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Apr 17, 2006 Accepting new patients
Stockton Diagnostic Imaging Diagnostic Radiology CurrentSince Dec 20, 2017 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Aug 13, 2017 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Aug 12, 2020 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 20, 2017 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Aug 12, 2012 Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Mar 1, 2019 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Apr 17, 2006 Accepting new patients
Santa Rosa Imaging Medical Center Diagnostic Radiology CurrentSince Dec 20, 2017 Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Mar 1, 2019 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Aug 13, 2017 Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology Current Accepting new patients
Desert Advanced Imaging Medical Center Diagnostic Radiology CurrentSince Apr 7, 2011 Accepting new patients
Fresno Imaging Center Diagnostic Radiology CurrentSince Jan 1, 2014 Accepting new patients
Modesto Advanced Diagnostic Imaging Medical Center Diagnostic Radiology CurrentSince Apr 15, 2010 Accepting new patients
Pomona Valley Imaging Medical Group Inc Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Memrad Medical Group Inc PastSince Jul 1, 2002 Accepting new patients
Radmol Pet Center, LLC Diagnostic Radiology PastSince Apr 15, 2010 Accepting new patients
Dignity Community Care Past Accepting new patients

Locations (25 of 44)

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

2301 Bahamas Dr
Bakersfield, CA 93309

9330 Stockdale Hwy
Ste 100
Bakersfield, CA 93311
Phone (661) 325-6800

1817 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 325-6800

3838 San Dimas St
Ste A120
Bakersfield, CA 93301
Phone (661) 328-9600

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

2201 Walnut Ave
Ste 150
Fremont, CA 94538
Phone (510) 713-1234

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

2699 Atlantic Ave
Long Beach, CA 90806
Phone (562) 426-2105

8436 W 3rd St
Ste 801
Los Angeles, CA 90048
Phone (310) 358-2100

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

1510 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2851

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1386626729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 COTNER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253303",
            "telephone_number": "310-445-2951",
            "fax_number": "310-479-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 COTNER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253303",
            "telephone_number": "310-445-2951",
            "fax_number": "310-479-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGMAN",
        "first_name": "ALLAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G27772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G277720",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0106039",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.