Individual provider Active NPI

Marshall Jay Seligmann, M.D.

  • Pediatrics Physician
  • Tarzana, CA
National Provider Identifier
1518198183
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A107417 Issued in CA
Practice address
18555 Ventura Blvd
Suite B
Tarzana, CA 91356-4191
Phone
(818) 614-3088
Fax
(818) 614-3087
NPI assigned
Jul 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A107417 CA Primary

Addresses

Primary practice location

18555 Ventura Blvd
Suite B
Tarzana, CA 91356-4191

Mailing address

18555 Ventura Blvd
Suite B
Tarzana, CA 91356-4191
Phone (818) 614-3088

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20100826000552 CA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8921122052 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107417CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1518198183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18555 VENTURA BLVD",
            "address_2": "SUITE B",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564191",
            "telephone_number": "818-614-3088",
            "fax_number": "818-614-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18555 VENTURA BLVD",
            "address_2": "SUITE B",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564191",
            "telephone_number": "818-614-3088",
            "fax_number": "818-614-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIGMANN",
        "first_name": "MARSHALL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A107417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.