Individual provider Active NPI

Luis Dimen, M.D.

  • Internal Medicine Physician
  • Pasadena, CA
National Provider Identifier
1609843564
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G76052 Issued in CA
Practice address
10 Congress St
Suite 208
Pasadena, CA 91105-3045
Phone
(626) 792-2166
Fax
(626) 795-0740
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X G76052 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X G76052 CA
Internal Medicine Physician 207R00000X G76052 CA Primary

Addresses

Primary practice location

10 Congress St
Suite 208
Pasadena, CA 91105-3045

Mailing address

10 Congress St
Sutie 208
Pasadena, CA 91105-3045
Phone (626) 792-2166

Other identifiers 1

IdentifierTypeStateIssuer
00G760520MedicaidCA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070219000824 CA Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0244332492 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76052CAMDClinical Social Worker
G76052CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Foothill Pulmonary & Critical Care Consultants Medical Group Inc. Internal Medicine CurrentSince Jul 29, 1996 Accepting new patients
Pasadena Hosptial Association, LTD. Internal Medicine CurrentSince Feb 14, 2010 Accepting new patients
Huntington Pathology Medical Group Inc Current Accepting new patients
The Huntington Medical Foundation Internal Medicine CurrentSince Oct 26, 2009 Accepting new patients
Pasadena Hospital Association, LTD. CurrentSince Feb 14, 2010 Accepting new patients

Locations

711 Fairmount Ave
Pasadena, CA 91105
Phone (626) 397-3366

959 E Walnut St
Ste 120
Pasadena, CA 91106
Phone (626) 795-1831

65 N Madison Ave
Ste 800
Pasadena, CA 91101
Phone (626) 792-3141

10 Congress St
Ste 208
Pasadena, CA 91105
Phone (626) 792-2166

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1609843564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CONGRESS ST",
            "address_2": "SUTIE 208",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053045",
            "telephone_number": "626-792-2166",
            "fax_number": "626-795-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONGRESS ST",
            "address_2": "SUITE 208",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053045",
            "telephone_number": "626-792-2166",
            "fax_number": "626-795-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMEN",
        "first_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G76052",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G76052",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G76052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G760520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.