Individual provider Active NPI

Andrew Jay Fishmann, MD

  • Pulmonary Disease Physician
  • Los Angeles, CA
National Provider Identifier
1407936198
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
G44744 Issued in CA
Practice address
1245 Wilshire Blvd Ste 503
Los Angeles, CA 90017-4805
Phone
(213) 977-4979
Fax
(213) 977-0544
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G44744 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X G44744 CA
Pulmonary Disease Physician 207RP1001X G44744 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd Ste 503
Los Angeles, CA 90017-4805

Mailing address

1245 Wilshire Blvd Ste 503
Los Angeles, CA 90017-4805
Phone (213) 977-4979

Other identifiers 1

IdentifierTypeStateIssuer
00G4477440MedicaidCA

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
I20101102000618 CA Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3476516717 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G44744CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Lung Associates Internal Medicine CurrentSince Jan 1, 1989 Accepting new patients

Locations

1245 Wilshire Blvd
Ste 503
Los Angeles, CA 90017
Phone (213) 389-3200

1245 Wilshire Blvd
Ste 407
Los Angeles, CA 90017
Phone (213) 747-7307

Organizations & group practices 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1407936198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 503",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174805",
            "telephone_number": "213-977-4979",
            "fax_number": "213-977-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 503",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174805",
            "telephone_number": "213-977-4979",
            "fax_number": "213-977-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMANN",
        "first_name": "ANDREW",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G44744",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G44744",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G44744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G4477440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.