Igor Persidsky, M.D

Primary specialty

SpecialistTaxonomy code 174400000X

License

A54121 Issued in CA

Practice address

5434 Heron Bay
Long Beach, CA 90803-4821

Phone

(562) 985-0619

Fax

(562) 498-4601

NPI assigned

Jul 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

University of Southern California Keck School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Affinity Home Health, Inc Home health agency, Culver City, CA, CCN 059202
• Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• House Calls Medical Corporation

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1598787574
  Medicare reassignment Authorized official
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)

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

• Affinity Home Health, Inc.

  • Home Health Agency
  • Culver City, CA
  • NPI 1043404742
  Care Compare affiliation
• Long Beach Memorial Medical

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1962442012
  Care Compare affiliation

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1437188299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5434 HERON BAY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034821",
            "telephone_number": "562-985-0619",
            "fax_number": "562-498-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5434 HERON BAY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034821",
            "telephone_number": "562-985-0619",
            "fax_number": "562-498-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSIDSKY",
        "first_name": "IGOR",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A54121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A541211",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Susanne Perrotta, MA, CCC-SLP
• Amanda Perry
• Henry Lewis Perry, RN
• Pattriana Perry
• Zanetta D Perry, LVN
• Kim Person
• Scott Anthony Persson
• Pesl LLC
• John F Petek, LCSW
• Peter Foldvary MD a Professional Corporation

• Specialist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.