NPIMap

Individual provider Active NPI

William L Madrid, M.D.

  • Cardiovascular Disease Physician
  • Lakewood, CA
National Provider Identifier
1467419366
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A48312 Issued in CA
Practice address
3650 South St Ste 310
Lakewood, CA 90712-1519
Phone
(562) 531-1980
Fax
(562) 531-7952
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A48312 CA Primary

Addresses

Primary practice location

3650 South St Ste 310
Lakewood, CA 90712-1519

Mailing address

3650 South St
Ste. #310
Lakewood, CA 90712-1502
Phone (562) 531-1980

Other identifiers 1

IdentifierTypeStateIssuer
00A483120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080604000749 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2567532393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

3650 E S St
Suite 310
Lakewood, CA 90712-1519
Phone (562) 531-1980

Hospital & facility affiliations

  • Uci Health-Lakewood Hospital, Lakewood, CA, CCN 050581
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48312CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Cardiovascular Disease Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Prohealth Partners, a Medical Group, Inc. Cardiovascular Disease CurrentSince Jul 1, 2015 Accepting new patients
University of California Irvine Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

3650 South St
Ste 303
Lakewood, CA 90712
Phone (563) 633-9734

3650 South St
Ste 310
Lakewood, CA 90712
Phone (310) 531-1980

3650 South St
Ste 210
Lakewood, CA 90712
Phone (562) 630-0910

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 4

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1467419366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST",
            "address_2": "STE. #310",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121502",
            "telephone_number": "562-531-1980",
            "fax_number": "562-531-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 310",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121519",
            "telephone_number": "562-531-1980",
            "fax_number": "562-531-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRID",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A48312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A483120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.