Individual provider Active NPI

Stephen B Fierstien, M.D.

  • Diagnostic Radiology Physician
  • Beverly Hills, CA
National Provider Identifier
1447212188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G21040 Issued in CA
Practice address
145 S Doheny Dr
Beverly Hills, CA 90211-2509
Phone
(310) 550-5858
Fax
(310) 550-5775
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
Yes

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
Diagnostic Radiology Physician 2085R0202X G21040 CA Primary

Addresses

Primary practice location

145 S Doheny Dr
Beverly Hills, CA 90211-2509

Mailing address

145 S Doheny Dr
Beverly Hills, CA 90211-2509
Phone (310) 550-5858

Other identifiers 1

IdentifierTypeStateIssuer
00G210400OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Advanced Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Feb 1, 2013 Accepting new patients
Stephen B. Fierstien, M.D.,Inc. Diagnostic Radiology PastSince Oct 1, 1997 Accepting new patients

Locations

145 S Doheny Dr
Beverly Hills, CA 90211
Phone (310) 550-5858

10767 Riverside Dr
North Hollywood, CA 91602
Phone (818) 301-6700

Organizations & group practices 2

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447212188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S DOHENY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112509",
            "telephone_number": "310-550-5858",
            "fax_number": "310-550-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S DOHENY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112509",
            "telephone_number": "310-550-5858",
            "fax_number": "310-550-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIERSTIEN",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G21040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G210400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.