Individual provider Active NPI

Richard Greenspun, MD

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1417984600
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G25213 Issued in CA
Practice address
901 Wilshire Blvd FL 3
Santa Monica, CA 90401-1854
Phone
(310) 829-8903
Fax
(424) 212-5933
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 G25213 CA Primary

Addresses

Primary practice location

901 Wilshire Blvd FL 3
Santa Monica, CA 90401-1854

Mailing address

901 Wilshire Blvd FL 1
Santa Monica, CA 90401-1854
Phone (310) 829-8945

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgreenspun473201@oc.providencedirect.org

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
I20071018000409 CA Practitioner - Internal Medicine 2264528496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

901 Wilshire Blvd
FL 1
Santa Monica, CA 90401-1854
Phone (310) 829-8945

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Santa Monica Bay Area Physicians Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients

Locations

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

901 Wilshire Blvd
Fl 3
Santa Monica, CA 90401
Phone (310) 829-8903

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

901 Wilshire Blvd
Fl 1
Santa Monica, CA 90401
Phone (310) 829-8441

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1417984600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WILSHIRE BLVD FL 1",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011854",
            "telephone_number": "310-829-8945",
            "fax_number": "424-212-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WILSHIRE BLVD FL 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011854",
            "telephone_number": "310-829-8903",
            "fax_number": "424-212-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENSPUN",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G25213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgreenspun473201@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "901 Wilshire Blvd Fl 1",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904011854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.