Individual provider Active NPI

Robert Y Meyerson, MD

  • Family Medicine Physician
  • Panorama City, CA
National Provider Identifier
1629084983
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H1259 Issued in TX
Practice address
14427 Chase St Ste 100
Panorama City, CA 91402-3020
Phone
(818) 830-7751
Fax
(818) 891-7892
NPI assigned
Jul 31, 2006
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H1259 TX Primary

Addresses

Primary practice location

14427 Chase St Ste 100
Panorama City, CA 91402-3020

Mailing address

4101 Bradwood Rd
Austin, TX 78722-1132
Phone (512) 217-7187

Other practice location 1

4515 Seton Center Pkwy
Suite 220
Austin, TX 78759-5290
Phone (512) 338-8388

Other identifiers 4

IdentifierTypeStateIssuer
123752102MedicaidTX
123752105MedicaidTX
123752110MedicaidTX
123752111MedicaidTX

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
I20220809002812 CA Practitioner - Family Practice 9234228354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santo Nino Health CenterGroup PAC ID 6305200593, 13 clinicians

Practice addresses (Care Compare)

14427 Chase St
Panorama City, CA 91402-3020
Phone (818) 830-7751

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H1259TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santo Nino Health Center CurrentSince Jun 24, 2023 Accepting new patients
Innovative Medical Solutions Inc a Medical Group CurrentSince Aug 1, 2022 Accepting new patients

Locations

8920 Wilshire Blvd
Ste 310
Beverly Hills, CA 90211
Phone (310) 256-2426

14427 Chase St
Ste 100
Panorama City, CA 91402
Phone (818) 830-7751

14860 Roscoe Blvd
Ste 200
Panorama City, CA 91402
Phone (818) 830-7751

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1629084983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 BRADWOOD RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787221132",
            "telephone_number": "512-217-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14427 CHASE ST STE 100",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023020",
            "telephone_number": "818-830-7751",
            "fax_number": "818-891-7892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4515 Seton Center Pkwy",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787595290",
            "country_code": "US",
            "telephone_number": "512-338-8388",
            "fax_number": "512-406-6274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYERSON",
        "first_name": "ROBERT",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H1259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123752102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123752105",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123752110",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123752111",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.