Active NPI
Valley Anesthesia Physicians Medical Group, Inc
- Anesthesiology Physician
- Northridge, CA
National Provider Identifier
1649895186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- VALLEY ANESTHESIA PHYSICIANS MEDICAL GROUP, INC
- Practice address
- 18300 Roscoe Blvd
Northridge, CA 91325-4105 - Phone
- (818) 885-8500
- NPI assigned
- Jun 10, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alexander Seliverstov, M.D.
- Title
- Managing Partner
- Phone
- (949) 588-2190
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
18300 Roscoe Blvd
Northridge, CA 91325-4105
Mailing address
5 Holland
#101
Irvine, CA 92618-2568
Phone (949) 588-2190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200623002749 | CA | Part B Supplier - Clinic/Group Practice | 2961824891 |
Receives reassigned benefits from 22 practitioners Practice locations: Northridge, CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 24
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Anesthesiology Physician
- Los Angeles, CA
- NPI 1285193342
Anesthesiology, CA
-
- Anesthesiology Physician
- Van Nuys, CA
- NPI 1275997223
Anesthesiology, CA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623628800000",
"number": "1649895186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 HOLLAND",
"address_2": "#101",
"city": "IRVINE",
"state": "CA",
"postal_code": "926182568",
"telephone_number": "949-588-2190",
"fax_number": "949-588-2199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 ROSCOE BLVD",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913254105",
"telephone_number": "818-885-8500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VALLEY ANESTHESIA PHYSICIANS MEDICAL GROUP, INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-06-10",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A",
"authorized_official_last_name": "SELIVERSTOV",
"authorized_official_first_name": "ALEXANDER",
"authorized_official_title_or_position": "MANAGING PARTNER",
"authorized_official_telephone_number": "949-588-2190",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.