Individual provider Active NPI

Jeremy E Korman, M.D.

  • Surgery Physician
  • Marina del Rey, CA
National Provider Identifier
1508870171
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G83221 Issued in CA
Practice address
4644 Lincoln Blvd
Ste 450
Marina del Rey, CA 90292-6313
Phone
(800) 491-1977
Fax
(310) 577-5616
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G83221 CA Primary

Addresses

Primary practice location

4644 Lincoln Blvd
Ste 450
Marina del Rey, CA 90292-6313

Mailing address

4644 Lincoln Blvd
Ste 450
Marina del Rey, CA 90292-6313
Phone (310) 577-5540

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
I20101112000339 CA Practitioner - General Surgery 5991990210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Icahn School of Medicine at Mount Sinai, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4640 Admiralty Way
Suite 901
Marina del Rey, CA 90292-6621
Phone (424) 488-7112

4644 Lincoln Blvd
Marina del Rey, CA 90292-6374

Hospital & facility affiliations

  • Cedar-Sinai Marina del Rey Hospital Hospital, Marina del Rey, CA, CCN 050740

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
La Surgical Specialists Surgery Current Accepting new patients
Jeremy E Korman MD a Professional Corporation Surgery CurrentSince Apr 30, 2003 Accepting new patients
Jeremy E. Korman MD, a Professional Corporation Current Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

4640 Admiralty Way
Ste 901
Marina del Rey, CA 90292
Phone (310) 557-5540

4644 Lincoln Blvd
Ste 450
Marina del Rey, CA 90292
Phone (310) 325-4415

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jkorman103103@direct.cshs.org

Organizations & group practices 5

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 1

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1508870171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "STE 450",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-577-5540",
            "fax_number": "310-577-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "STE 450",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "800-491-1977",
            "fax_number": "310-577-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORMAN",
        "first_name": "JEREMY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G83221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.