Individual provider Active NPI

Martin Louis Chenevert, M.D.

  • Emergency Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1386678746
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G067565 Issued in CA
Practice address
1250 16TH St
Santa Monica-UCLA Medical Center, Emergency Dept.
Santa Monica, CA 90404-1249
Phone
(424) 259-8405
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G067565 CA Primary

Addresses

Primary practice location

1250 16TH St
Santa Monica-UCLA Medical Center, Emergency Dept.
Santa Monica, CA 90404-1249

Mailing address

1990 N California Blvd
Suite 400
Walnut Creek, CA 94596-3742
Phone (925) 482-2811

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
I20110307000631 CA Practitioner - Emergency Medicine 5890977219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
93.25
Promoting interoperability
100
Improvement activities
40
Cost
79.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G067565CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vep MLK Emergency Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Capital Hospitalist Medical Group Inc Emergency Medicine CurrentSince Mar 1, 2016 Accepting new patients
Regents of the Univ of Ca Emer Med Emergency Medicine CurrentSince Feb 1, 2020 Accepting new patients
The Regents of the University of California Past Accepting new patients
UCLA Medical Group Emergency Medicine Past Accepting new patients

Locations

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

File 55675
Los Angeles, CA 90074

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

Interoperability endpoints

  • Direct secure messaging: mchenevert60002@direct.uclahealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1386678746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 N CALIFORNIA BLVD",
            "address_2": "SUITE 400",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963742",
            "telephone_number": "925-482-2811",
            "fax_number": "925-482-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 16TH ST",
            "address_2": "SANTA MONICA-UCLA MEDICAL CENTER, EMERGENCY DEPT.",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "424-259-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENEVERT",
        "first_name": "MARTIN",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G067565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.