NPIMap

Individual provider Active NPI

Douglas Edward Schreck, MD

  • Cardiovascular Disease Physician
  • Burbank, CA
National Provider Identifier
1568558245
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G42723 Issued in CA
Practice address
201 S Buena Vista St
Suite 100
Burbank, CA 91505-4569
Phone
(818) 848-6404
Fax
(818) 848-7112
NPI assigned
Oct 4, 2006
Last updated
Jul 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G42723 CA Primary

Addresses

Primary practice location

201 S Buena Vista St
Suite 100
Burbank, CA 91505-4569

Mailing address

3452 E Foothill Blvd
Suite 130
Pasadena, CA 91107-3142
Phone (626) 793-2885

Other identifiers 2

IdentifierTypeStateIssuer
W2223COtherCAPTAN
00G427230MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000321 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789682436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
New York Medical College, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

201 S Buena Vista St
Suite 100
Burbank, CA 91505-4570

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G42723CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Current Accepting new patients
Providence Medical Institute CurrentSince Dec 1, 2015 Accepting new patients
Providence Medical Institute CurrentSince Dec 1, 2015 Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

201 S Buena Vista St
Ste 100
Burbank, CA 91505
Phone (818) 848-6404

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

1808 Verdugo Blvd
Ste 414
Glendale, CA 91208
Phone (818) 265-5400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dschreck435715@oc.providencedirect.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1568558245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 E FOOTHILL BLVD",
            "address_2": "SUITE 130",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073142",
            "telephone_number": "626-793-2885",
            "fax_number": "626-793-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S BUENA VISTA ST",
            "address_2": "SUITE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054569",
            "telephone_number": "818-848-6404",
            "fax_number": "818-848-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRECK",
        "first_name": "DOUGLAS",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G42723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W2223C",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G427230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.