Neil Ira Chafetz, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G29504 Issued in CA

Practice address

1360 W 6TH St
West BLDG - Ste. 100
San Pedro, CA 90732-3514

Phone

(310) 833-2233

Fax

(310) 833-2213

NPI assigned

Feb 27, 2007

Last updated

May 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Neil I. Chafetz, M.D. Inc

  • Specialist
  • San Pedro, CA
  • NPI 1649389545
  Medicare reassignment NPD Authorized official
• Oracle Imaging Inc.

  dba Oracle Imaging Center

  • Radiology Clinic/Center
  • Riverside, CA
  • NPI 1952924599
  NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1568599678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 W 6TH STREET",
            "address_2": "WEST BLDG STE 150",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-833-1724",
            "fax_number": "888-469-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "address_2": "WEST BLDG - STE. 100",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323514",
            "telephone_number": "310-833-2233",
            "fax_number": "310-833-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFETZ",
        "first_name": "NEIL",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G29504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G295042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minerva Ceja, TCH
• Doris Renee Celi, APRN
• Diana Centeno-Sicairos
• Denise Cervantes, AMFT
• Lucero Gonzalez Chacon
• Onintr Chanthanasuksilpa
• Matthew Chapin
• Charles Brown Healthcare, a Medical Corporation
• Charles Etuk
• Breanna J Charles, LMFT

• Specialist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.