Individual provider Active NPI

Alexis Zumbrunn, MD

  • Emergency Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1629697263
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A196171 Issued in CA
Practice address
15107 Vanowen St
Van Nuys, CA 91405-4542
Phone
(818) 782-6600
NPI assigned
Apr 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A196171 CA Primary

Addresses

Primary practice location

15107 Vanowen St
Van Nuys, CA 91405-4542

Mailing address

5009 Woodman Ave Apt 205
Sherman Oaks, CA 91423-1342

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
I20241017002098 CA Practitioner - Emergency Medicine 9537691399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Presbyterian Emergency Medical AssociatesGroup PAC ID 1951308105, 10 clinicians

Practice addresses (Care Compare)

15107 Vanowen St
Van Nuys, CA 91405-4542
Phone (818) 902-2990

Hospital & facility affiliations

  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761
  • Valley Presbyterian Hospital Hospital, Van Nuys, CA, CCN 050126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A196171CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine CurrentSince Aug 11, 2024 Accepting new patients
Tarzana Emergency Medical Associates Emergency Medicine CurrentSince Aug 11, 2024 Accepting new patients

Locations

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1629697263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 WOODMAN AVE APT 205",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15107 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054542",
            "telephone_number": "818-782-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUMBRUNN",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A196171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.