Individual provider Active NPI

Bruce W Kovacs, M.D.

  • Maternal & Fetal Medicine Physician
  • Whittier, CA
National Provider Identifier
1629074976
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
G42117 Issued in CA
Practice address
12401 Whittier Blvd
Whittier, CA 90602-1018
Phone
(562) 693-7778
Fax
(562) 693-3681
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X G42117 CA Primary

Addresses

Primary practice location

12401 Whittier Blvd
Whittier, CA 90602-1018

Mailing address

PO Box 3389
Seal Beach, CA 90740-2389
Phone (562) 773-3155

Other identifiers 1

IdentifierTypeStateIssuer
00G421170MedicaidCA

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
I20120430000260 CA Practitioner - Obstetrics/Gynecology 3971765470 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42117CAMDGeneral Practice Dentistry
G42117CAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce W. Kovacs, MD Inc Maternal & Fetal Medicine CurrentSince Feb 12, 2012 Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients
Usc Obstetricians and Gynecologists, Inc. Maternal & Fetal Medicine Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

12555 Garden Grove Blvd
Ste 203
Garden Grove, CA 92843
Phone (562) 491-9809

12601 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5160

9200 Colima Rd
Ste 107
Whittier, CA 90605
Phone (562) 773-3155

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

9080 Colima Rd
Whittier, CA 90605
Phone (562) 907-1565

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1629074976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3389",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402389",
            "telephone_number": "562-773-3155",
            "fax_number": "562-498-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 WHITTIER BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021018",
            "telephone_number": "562-693-7778",
            "fax_number": "562-693-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACS",
        "first_name": "BRUCE",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "G42117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G421170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.