Jeremy Ethan Levenson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A22502 Issued in CA

Practice address

2125 Arizona Ave
Santa Monica, CA 90404-1337

Phone

(310) 829-8701

Fax

(310) 315-4062

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1659304590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6654 KENTWOOD BLUFFS DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451259",
            "telephone_number": "310-216-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 ARIZONA AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041337",
            "telephone_number": "310-829-8701",
            "fax_number": "310-315-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENSON",
        "first_name": "JEREMY",
        "middle_name": "ETHAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A22502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00178725",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A225020",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlevenson872245@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2125 Arizona Ave",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904041337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaron Leu-Pierre
• Hobart Leung, M.D.
• Alexis Ann Levee, MD
• Abigail Rachel Leven, OTR/L
• Jill Levenberg
• Michael Levi, D.P.M.
• Naomi Levi
• Roya Elyaszadeh Levi, DDS
• Amy Charlene Levin
• Robert E Levin, M.D.

• Ophthalmology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.