NPIMap

Organization Active NPI

Sherman Oaks Integrated Medical Group, Inc.

Doing business as Health Atlast Sherman Oaks

  • Physical Medicine & Rehabilitation Physician
  • Sherman Oaks, CA
National Provider Identifier
1588028625
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A102275 Issued in CA
Legal business name
SHERMAN OAKS INTEGRATED MEDICAL GROUP, INC.
Doing business as
Health Atlast Sherman Oaks
Practice address
4835 Van Nuys Blvd
Suite 105
Sherman Oaks, CA 91403-2109
Phone
(818) 786-5985
Fax
(818) 786-6849
NPI assigned
Apr 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Authorized official

Name
Bryce MatthewsNPI 1164732012
Title
Minority Owner
Phone
(818) 786-5985

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X A102275 CA Primary

Addresses

Primary practice location

4835 Van Nuys Blvd
Suite 105
Sherman Oaks, CA 91403-2109

Mailing address

4835 Van Nuys Blvd
Suite 105
Sherman Oaks, CA 91403-2109
Phone (818) 786-5985

Other names 1

  • Health Atlast Sherman Oaks Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161209001402 CA Part B Supplier - Clinic/Group Practice 8729368659 Receives reassigned benefits from 7 practitioners
Practice locations: Sherman Oaks, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1588028625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD",
            "address_2": "SUITE 105",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032109",
            "telephone_number": "818-786-5985",
            "fax_number": "818-786-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD",
            "address_2": "SUITE 105",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032109",
            "telephone_number": "818-786-5985",
            "fax_number": "818-786-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERMAN OAKS INTEGRATED MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_title_or_position": "MINORITY OWNER",
        "authorized_official_telephone_number": "818-786-5985"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A102275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Atlast Sherman Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.