Active NPI
Ann Marie T Levan, M.D.
- Diagnostic Radiology Physician
- Long Beach, CA
National Provider Identifier
1629017512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- A44196
- Practice address
- 1045 Atlantic Ave
Suite 105
Long Beach, CA 90813 - Phone
- (562) 491-9167
- Fax
- (562) 491-7969
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A44196 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | A44196 | CA | Primary |
Addresses
Primary practice location
1045 Atlantic Ave
Suite 105
Long Beach, CA 90813
Mailing address
1045 Atlantic Ave
Suite 105
Long Beach, CA 90813-3408
Phone (562) 491-9167
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HW8412A | Other | CA | PTAN/LEGACY PACIFIC HOSP |
| HW881 | Other | CA | ST MARYS PTAN |
| 00A441960 | Medicaid | CA | |
| HW8412B | Other | CA | PTAN/LEGACY COMMUNITY HOSP |
| HW8412 | Other | CA | GROUP PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A44196 | CA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1629017512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 ATLANTIC AVE",
"address_2": "SUITE 105",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133408",
"telephone_number": "562-491-9167",
"fax_number": "562-491-7969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 ATLANTIC AVE",
"address_2": "SUITE 105",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90813",
"telephone_number": "562-491-9167",
"fax_number": "562-491-7969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVAN",
"first_name": "ANN MARIE",
"middle_name": "T",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A44196",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A44196",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN/LEGACY PACIFIC HOSP",
"identifier": "HW8412A",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ST MARYS PTAN",
"identifier": "HW881",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A441960",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN/LEGACY COMMUNITY HOSP",
"identifier": "HW8412B",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "HW8412",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.