Organization Active NPI

Saint Johns Emergency Medicine Specialists Inc a Medical Group

  • Emergency Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1609888940
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SAINT JOHNS EMERGENCY MEDICINE SPECIALISTS INC A MEDICAL GROUP
Practice address
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone
(310) 829-5511
NPI assigned
Aug 13, 2006
Last updated
Dec 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Michael J Weitz, MD
Title
Cfo
Phone
(310) 582-7089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Mailing address

PO Box 4419
Woodland Hills, CA 91365-4419
Phone (818) 340-9988

Other identifiers 1

IdentifierTypeStateIssuer
GR0062990MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031217001093 CA Part B Supplier - Clinic/Group Practice 9335046291 Receives reassigned benefits from 48 practitioners
Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Locations

1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511

Practitioners & affiliated clinicians

Practitioners 49

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.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1609888940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "818-340-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "310-829-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOHNS EMERGENCY MEDICINE SPECIALISTS INC A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "WEITZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-582-7089",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.