Individual provider Active NPI

Laxmi Sudarshan Iyer, M.D.,

  • Hematology & Oncology Physician
  • Riverside, CA
National Provider Identifier
1508185406
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A165408 Issued in CA
Practice address
4500 Brockton Ave Ste 107
Riverside, CA 92501-4006
Phone
(951) 276-2760
Fax
(951) 276-2960
NPI assigned
May 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X A165408 CA
Hematology & Oncology Physician 207RH0003X A165408 CA Primary

Addresses

Primary practice location

4500 Brockton Ave Ste 107
Riverside, CA 92501-4006

Mailing address

6827 W Tropicana Ave Ste 110
Las Vegas, NV 89103-4920
Phone (800) 881-4226

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
I20200330000214 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 4880993922 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Los Angeles Hematology-Oncology Medical GroupGroup PAC ID 6608819594, 51 clinicians
Compassionate Cancer Care Medical Group IncGroup PAC ID 0941285399, 5 clinicians

Practice addresses (Care Compare)

1245 Wilshire Blvd
Suite 303
Los Angeles, CA 90017-4803
Phone (213) 977-1214

260 E Ontario Ave
Suite 101
Corona, CA 92879-3508
Phone (951) 371-2411

4500 Brockton Ave
Suite 107
Riverside, CA 92501-4006
Phone (951) 276-2760

Hospital & facility affiliations

  • Riverside Community Hospital Hospital, Riverside, CA, CCN 050022
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A165408CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Hematology-Oncology Medical Group Hematology & Oncology CurrentSince Jun 1, 2024 Accepting new patients
Los Angeles Hematology-Oncology Medical Group Hematology & Oncology CurrentSince Jun 1, 2024 Accepting new patients
Compassionate Cancer Care Medical Group, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Los Angeles Cardiology Associates Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 103
Anaheim, CA 92801
Phone (714) 535-3660

260 E Ontario Ave
Ste 101
Corona, CA 92879
Phone (951) 268-7746

11180 Warner Ave
Ste 351
Fountain Vly, CA 92708
Phone (714) 210-2300

1505 Wilson Ter
Ste 200
Glendale, CA 91206
Phone (818) 243-0477

23961 Calle de la Magdalena
Ste 501
Laguna Hills, CA 92653
Phone (714) 698-0300

3801 Katella Ave
Ste 207
Los Alamitos, CA 90720
Phone (562) 598-9745

1245 Wilshire Blvd
Ste 303
Los Angeles, CA 90017
Phone (213) 977-1214

1910 Royalty Dr
Pomona, CA 91767
Phone (844) 400-2236

4500 Brockton Ave
Ste 107
Riverside, CA 92501
Phone (951) 276-2760

15211 Vanowen St
Ste 201
Van Nuys, CA 91405
Phone (818) 574-3798

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1508185406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6827 W TROPICANA AVE STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034920",
            "telephone_number": "800-881-4226",
            "fax_number": "702-960-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE STE 107",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014006",
            "telephone_number": "951-276-2760",
            "fax_number": "951-276-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYER",
        "first_name": "LAXMI",
        "middle_name": "SUDARSHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "A165408",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A165408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.