David Samuel Tichansky, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C190984 Issued in CA

Practice address

200 Medical Plaza Suite 214
Los Angeles, CA 90095-5563

Phone

(310) 794-7788

NPI assigned

Apr 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

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

Specialty

General Surgery

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

UCLA Associated General SurgeonsGroup PAC ID 6002728144, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lac/Olive View-UCLA Medical Center Hospital, Sylmar, CA, CCN 050040
• Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• UCLA Associated General Surgeons

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1730147372
  Medicare reassignment Care Compare group NPD
• Regents Univ of Calif Los Angeles

  • Psychiatric Hospital
  • Los Angeles, CA
  • NPI 1952308363
  NPD (past)
• UCLA Associated General Surgeons

  • Surgery Physician
  • Santa Monica, CA
  • NPI 1821056458
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248

  Surgery

  NPD (past)
• NJ Bariatrics PC

  • Specialist
  • Plainsboro, NJ
  • NPI 1548398175

  Surgery

  NPD (past)
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  NPD (past)

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

• County of Los Angeles

  • General Acute Care Hospital
  • Sylmar, CA
  • NPI 1134143415
  Care Compare affiliation
• Regents of the Univ of California

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1427055839
  Care Compare affiliation

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1649236423",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA SUITE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900955563",
            "telephone_number": "310-794-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICHANSKY",
        "first_name": "DAVID",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD066823L",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "38725",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07587100",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C190984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022206230001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0177369",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3895577",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Eugene Tibone, MD
• Luz Ticas
• Alison Ann Tice, R.D.N
• Kristin Tice, LCSW
• Tarren Tice
• Joseph Tichio, D.C.
• Laura Ticho
• Roma Tickoo, M.D., M.P.H.
• Allie Ticktin, MA, OTR/L, OTD-C
• Marijem Ticzon

• Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.

Verify at the official NPI Registry.