Individual provider Active NPI

Susan Bookheimer, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1609807569
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14229 Issued in CA
Practice address
300 Medical PLZ
Los Angeles, CA 90095-0001
Phone
(310) 825-9989
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY14229 CA
Clinical Psychologist 103TC0700X PSY14229 CA Primary

Addresses

Primary practice location

300 Medical PLZ
Los Angeles, CA 90095-0001

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

Other practice location 1

760 Westwood Plz Ste 17-369
Los Angeles, CA 90095-0001
Phone (310) 794-6386

Other identifiers 1

IdentifierTypeStateIssuer
PSY142290MedicaidCA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040127001231 CA Practitioner - Clinical Psychologist 8921901000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 0749180453, 148 clinicians

Practice addresses (Care Compare)

300 Medical PLZ
Suite 2200
Los Angeles, CA 90095-6968
Phone (310) 825-9989

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
76.01
Promoting interoperability
100
Improvement activities
40
Cost
56.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY14229CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Radiology Medical Group CurrentSince Jul 1, 2015 Accepting new patients
UC Regents Clinical CurrentSince Jul 1, 2003 Accepting new patients
UCLA Medical Group Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

300 UCLA Medical Plz
Ste B130
Los Angeles, CA 90095
Phone (310) 206-0456

760 Westwood Plz
Ste 17369
Los Angeles, CA 90095
Phone (310) 794-6386

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

300 Medical Plz
Ste B100
Los Angeles, CA 90095
Phone (310) 267-6675

100 Moody Ct
Thousand Oaks, CA 91360
Phone (805) 418-3500

Organizations & group practices 4

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1609807569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Westwood Plz Ste 17-369",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900950001",
            "country_code": "US",
            "telephone_number": "310-794-6386",
            "fax_number": "310-206-1866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOKHEIMER",
        "first_name": "SUSAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY14229",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY142290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.