Individual provider Active NPI

Sofia Vaisman, M.D.

  • Adult Medicine Physician
  • Woodland Hills, CA
National Provider Identifier
1497846638
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A036979 Issued in CA
Practice address
22600 Ventura Blvd Ste 101
Woodland Hills, CA 91364-1430
Phone
(818) 225-1255
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X A036979 CA Primary
General Practice Physician 208D00000X A036979 CA

Addresses

Primary practice location

22600 Ventura Blvd Ste 101
Woodland Hills, CA 91364-1430

Mailing address

22600 Ventura Blvd Ste 101
Woodland Hills, CA 91364-1430
Phone (818) 225-1255

Other identifiers 2

IdentifierTypeStateIssuer
00A369790MedicaidCA
010017655OtherCARAILROAD MEDICARE

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
I20120615000531 CA Practitioner - Family Practice 4981868213 Practice locations: Woodland Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22600 Ventura Blvd
Suite 101
Woodland Hills, CA 91364-1430
Phone (818) 225-1255

Hospital & facility affiliations

  • Aca Home Health Care Inc Home health agency, Thousand Oaks, CA, CCN 059341
  • Planet Home Health Care, Inc Home health agency, Glendale, CA, CCN 059231
  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761
  • UCLA West Valley Medical Center Hospital, West Hills, CA, CCN 050481

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A036979CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Community Care Past Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients
West Hills Hospital Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: svaisman1358549@direct.uclahealth.org

Organizations & group practices 4

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1497846638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22600 VENTURA BLVD STE 101",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641430",
            "telephone_number": "818-225-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22600 VENTURA BLVD STE 101",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641430",
            "telephone_number": "818-225-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAISMAN",
        "first_name": "SOFIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A036979",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A036979",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A369790",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010017655",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.