Individual provider Active NPI

Vivy Tran Cusumano

  • Gastroenterology Physician
  • Santa Monica, CA
National Provider Identifier
1639600638
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A158805 Issued in CA
Practice address
1223 16TH St Ste 3100
Santa Monica, CA 90404-1275
Phone
(310) 582-6240
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A158805 CA Primary

Addresses

Primary practice location

1223 16TH St Ste 3100
Santa Monica, CA 90404-1275

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

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
I20230609002337 CA Practitioner - Gastroenterology 5890037022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Albert Einstein College of Medicine of Yeshiva University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1223 16TH St
Santa Monica, CA 90404-1217
Phone (424) 259-8859

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy24
Upper gastrointestinal (GI) endoscopy for acid reflux34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158805CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Gastroenterology CurrentSince Aug 1, 2023 Accepting new patients
The Regents of the University of California CurrentSince Aug 1, 2023 Accepting new patients
The Regents of the University of California General Acute Care Hospital Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

1223 16th St
Ste 3100
Santa Monica, CA 90404
Phone (310) 582-6240

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: vcusumano53824@direct.uclahealth.org

Organizations & group practices 4

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 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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1639600638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 16TH ST STE 3100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041275",
            "telephone_number": "310-582-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "VIVY",
        "middle_name": "TRAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A158805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.