Active NPI
Brooks V Udelsman, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- A190649
- Practice address
- 1450 San Pablo St Ste 6200
Los Angeles, CA 90033-5331 - Phone
- (323) 442-9062
- NPI assigned
- Jun 6, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | L-259070 | MA | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | A190649 | CA | Primary |
Addresses
Primary practice location
1450 San Pablo St Ste 6200
Los Angeles, CA 90033-5331
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601
Other practice location 1
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Phone (617) 726-2800
Other practice location 2
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
125 W Hungtington Dr
Arcadia, CA 91007-3050
1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582
1450 San Pablo St
Los Angeles, CA 90033-4500
1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444
1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273
1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273
1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273
300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000
Hospital & facility affiliations
- Keck Hospital of Usc
- Usc Arcadia Hospital
- Usc Kenneth Norris Jr Cancer Hospital
- Los Angeles General Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 28 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-259070 | MA | MD | Surgery Physician |
| A190649 | CA | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Surgery | Current | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
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.
-
dba Fair Oaks Clinic
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Los Angeles General Medical Center
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1598773715
-
dba Keck Hospital of USC
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1013514199
-
dba USC Kenneth Norris Jr. Hospital
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1417554528
-
- General Acute Care Hospital
- Arcadia, CA
- NPI 1508851288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1639582786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "626-457-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 SAN PABLO ST STE 6200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335331",
"telephone_number": "323-442-9062"
}
],
"practiceLocations": [
{
"address_1": "Massachusetts General Hospital",
"address_2": "55 Fruit Street",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "02114",
"country_code": "US",
"telephone_number": "617-726-2800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20 York St",
"address_purpose": "LOCATION",
"city": "New Haven",
"state": "CT",
"postal_code": "065103220",
"country_code": "US",
"telephone_number": "203-688-4242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UDELSMAN",
"first_name": "BROOKS",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-06",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "L-259070",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "CA",
"license": "A190649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.