Individual provider Active NPI

Aelred Boyle, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1417086489
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G88639 Issued in CA
Practice address
1224 Vine St
Los Angeles, CA 90038-1612
Phone
(323) 769-6100
Fax
(323) 467-0297
NPI assigned
Mar 5, 2007
Last updated
May 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G88639 CA Primary
Psychiatry Physician 2084P0800X 194577 NY

Addresses

Primary practice location

1224 Vine St
Los Angeles, CA 90038-1612

Mailing address

1224 Vine St
Los Angeles, CA 90038-1612
Phone (323) 769-6100

Other identifiers 1

IdentifierTypeStateIssuer
01862564MedicaidNY

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
I20120612000363 CA Practitioner - Psychiatry 2062318389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albert Einstein College of Medicine of Yeshiva University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1224 Vine St
Los Angeles, CA 90038-1612
Phone (323) 769-6100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G88639CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Apr 18, 2012 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Apr 18, 2012 Accepting new patients

Locations

20151 Nordhoff St
Chatsworth, CA 91311
Phone (818) 407-3200

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

11080 W Olympic Blvd
Fl 1
Los Angeles, CA 90064
Phone (310) 966-6610

1224 Vine St
Los Angeles, CA 90038
Phone (323) 769-6100

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1417086489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 VINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381612",
            "telephone_number": "323-769-6100",
            "fax_number": "323-467-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 VINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381612",
            "telephone_number": "323-769-6100",
            "fax_number": "323-467-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "AELRED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G88639",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "194577",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01862564",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.