Individual provider Active NPI

Johannes Benjamin Pulst-Korenberg, MD

  • Neurocritical Care Physician
  • Los Angeles, CA
National Provider Identifier
1558772368
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
A166240 Issued in CA
Practice address
1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315
Phone
(323) 442-5710
NPI assigned
May 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X A166240 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5710

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address johannes.pulst-korenberg@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200218000439 PA Practitioner - Neurology 3476805011 Reassigns benefits to 1 organization
I20200518002130 CA Practitioner - Neurology 3476805011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Michigan Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone (818) 790-7100

300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A166240CAMDNeurocritical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group Current Accepting new patients
Lancaster General Medical Group CurrentSince Feb 11, 2020 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2020 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2020 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 11, 2020 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

9033 Wilshire Blvd
Ste 300
Beverly Hills, CA 90211
Phone (310) 273-0330

1520 San Pablo St
Ste 3800
Los Angeles, CA 90033
Phone (323) 442-5720

1520 San Pablo St
Ste 3000
Los Angeles, CA 90033
Phone (323) 442-5728

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

426 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 299-1301

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 2

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": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1558772368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 3000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335315",
            "telephone_number": "323-442-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULST-KORENBERG",
        "first_name": "JOHANNES",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "CA",
            "license": "A166240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johannes.pulst-korenberg@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 3000",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.