Organization Active NPI

Vanessa Shana Rothholtz MD Inc

  • Otolaryngology Physician
  • Beverly Hills, CA
National Provider Identifier
1619390887
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
VANESSA SHANA ROTHHOLTZ MD INC
Practice address
414 N Camden Dr Ste 975
Beverly Hills, CA 90210
Phone
(310) 926-1573
Fax
(310) 926-1563
NPI assigned
Jan 23, 2014
Last updated
Jun 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Authorized official

Name
Ariel Weeks
Title
Billing Manager
Phone
(818) 850-0183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

414 N Camden Dr Ste 975
Beverly Hills, CA 90210

Mailing address

414 N Camden Dr Ste 975
Beverly Hills, CA 90210-4541
Phone (818) 850-0183

Other practice location 1

9461 Charleville Blvd Ste 451
Beverly Hills, CA 90212-3017
Phone (818) 850-0183

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140617001326 CA Part B Supplier - Clinic/Group Practice 5395969133 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2097143Vanessa Shana Rothholtz, MD Inc414 N Camden Dr Ste 975, Beverly Hills, CA 90210AccreditationMar 22, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1619390887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 N CAMDEN DR STE 975",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104541",
            "telephone_number": "818-850-0183",
            "fax_number": "310-201-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 N CAMDEN DR STE 975",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "310-926-1573",
            "fax_number": "310-926-1563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9461 Charleville Blvd Ste 451",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902123017",
            "country_code": "US",
            "telephone_number": "818-850-0183",
            "fax_number": "310-201-9665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VANESSA SHANA ROTHHOLTZ MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "WEEKS",
        "authorized_official_first_name": "ARIEL",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "818-850-0183"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.