Organization Active NPI

Sean Xie, M.D. a Medical Corporation

  • Neurological Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1497797716
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A85370 Issued in CA
Legal business name
SEAN XIE, M.D. A MEDICAL CORPORATION
Practice address
1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3067
Phone
(213) 977-1102
Fax
(213) 977-0656
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Authorized official

Name
Dr. Sean Xie, M.D.NPI 1447292966
Title
President
Phone
(213) 977-1102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X A85370 CA Primary

Addresses

Primary practice location

1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3067

Mailing address

PO Box 2077
Santa Monica, CA 90406-2077

Other identifiers 1

IdentifierTypeStateIssuer
00A853700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000548 CA Part B Supplier - Clinic/Group Practice 7618942632 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

100 S Raymond Ave
Alhambra, CA 91801
Phone (626) 457-7938

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584576000000",
    "number": "1497797716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904062077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153067",
            "telephone_number": "213-977-1102",
            "fax_number": "213-977-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN XIE, M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A",
        "authorized_official_last_name": "XIE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-977-1102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A85370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A853700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.