Individual provider Active NPI

Stephen Reale, M.D.

  • Internal Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1396846572
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G081738 Issued in CA
Practice address
15243 Vanowen St
Suite 101
Van Nuys, CA 91405-3605
Phone
(818) 994-5100
Fax
(818) 989-0297
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G081738 CA Primary

Addresses

Primary practice location

15243 Vanowen St
Suite 101
Van Nuys, CA 91405-3605

Mailing address

15243 Vanowen St
Suite 101
Van Nuys, CA 91405-3605
Phone (818) 780-2106

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
I20110106001031 CA Practitioner - Internal Medicine 6608065669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Connecticut School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JPB Medical Group IncGroup PAC ID 1355236290, 4 clinicians

Practice addresses (Care Compare)

15243 Vanowen St
Suite 101
Van Nuys, CA 91405-3636
Phone (818) 785-0300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G081738CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JPB Medical Group Inc Internal Medicine CurrentSince Dec 5, 2010 Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Dignity Community Care Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

15243 Vanowen St
Ste 101
Van Nuys, CA 91405
Phone (818) 780-2106

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sreale@jmg-ca.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396846572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "SUITE 101",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-780-2106",
            "fax_number": "818-780-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "SUITE 101",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-994-5100",
            "fax_number": "818-989-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REALE",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G081738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.