Individual provider Active NPI

Clifford Segil, D.O.

  • Neurology Physician
  • Santa Monica, CA
National Provider Identifier
1457556581
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
20A9399 Issued in CA
Practice address
2001 Santa Monica Blvd
860
Santa Monica, CA 90404-2102
Phone
(310) 828-3209
Fax
(310) 828-5165
NPI assigned
Jun 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 20A9399 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd
860
Santa Monica, CA 90404-2102

Mailing address

6029 Bristol Pkwy Ste 100
Culver City, CA 90230-4899
Phone (310) 417-5900

Other identifiers 3

IdentifierTypeStateIssuer
W14560COtherCAPTAN
20A9399MedicaidCA
W14560OtherCAPTAN

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
I20091027000200 CA Practitioner - NeurologyPractitioner - Psychiatry 6800933722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2001 Santa Monica Blvd
Suite 1170W
Santa Monica, CA 90404-2122
Phone (310) 828-8838

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9399CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clifford Segil DO a Medical Corporation Neurology CurrentSince Oct 10, 2011 Accepting new patients
Santa Monica Bay Area Physicians Neurology Past Accepting new patients

Locations

2001 Santa Monica Blvd
Ste 1170W
Santa Monica, CA 90404
Phone (310) 828-2212

2001 Santa Monica Blvd
Ste 1170
Santa Monica, CA 90404
Phone (310) 828-8838

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 3

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1457556581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6029 BRISTOL PKWY STE 100",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304899",
            "telephone_number": "310-417-5900",
            "fax_number": "310-410-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "860",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-828-3209",
            "fax_number": "310-828-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGIL",
        "first_name": "CLIFFORD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A9399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W14560C",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20A9399",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W14560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.