Individual provider Active NPI

Michael Denis Masterson, M.D.

  • Medical Oncology Physician
  • Westlake Village, CA
National Provider Identifier
1649240052
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
G27552 Issued in CA
Practice address
1250 La Venta
Suite 202
Westlake Village, CA 91361
Phone
(805) 496-5153
Fax
(805) 496-5202
NPI assigned
Jan 26, 2006
Last updated
Feb 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X G27552 CA Primary
Hematology (Internal Medicine) Physician 207RH0000X G27552 CA

Addresses

Primary practice location

1250 La Venta
Suite 202
Westlake Village, CA 91361

Mailing address

1250 La Venta
Suite 202
Westlake Village, CA 91361
Phone (805) 496-5153

Other identifiers 2

IdentifierTypeStateIssuer
WG27552AOtherCAMEDICARE PTAN
G27552OtherCAMEDICAL LICENSE

Other names 1

  • Michael Denis Masterson Other name

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
I20080521000770 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5597834127 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G27552CAMDMedical Oncology Physician
27552CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Dec 1, 2013 Accepting new patients
The Regents of the University of California CurrentSince Dec 1, 2013 Accepting new patients

Locations

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

File 55737
Los Angeles, CA 90074

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

1250 La Venta Dr
Ste 202
Westlake Vlg, CA 91361
Phone (805) 496-5153

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1649240052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 LA VENTA",
            "address_2": "SUITE 202",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "91361",
            "telephone_number": "805-496-5153",
            "fax_number": "805-496-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 LA VENTA",
            "address_2": "SUITE 202",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "91361",
            "telephone_number": "805-496-5153",
            "fax_number": "805-496-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "MICHAEL",
        "middle_name": "DENIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "G27552",
            "primary": true
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "CA",
            "license": "G27552",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WG27552A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G27552",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "MASTERSON",
            "middle_name": "DENIS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.