Rephana Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A64647 Issued in CA

Legal business name

REPHANA MEDICAL GROUP

Practice address

1304 15TH St Ste 402
Santa Monica, CA 90404-1813

Phone

(310) 451-0111

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Neal Shanblatt, MDNPI 1922092410

Title

President

Phone

(310) 451-0111

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neal Shanblatt, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
  • NPI 1922092410
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659414258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 W 3RD ST # 132",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362860",
            "telephone_number": "310-451-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 15TH ST STE 402",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041813",
            "telephone_number": "310-451-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REPHANA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANBLATT",
        "authorized_official_first_name": "NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-451-0111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A64647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A646470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Remy, LCSW
• Renal Treatment Centers California Inc (Mar Vista Dialysis Center)
• David Dale Renaud, M.D.
• Renee N Magana MD Inc
• Rochelle Marie Reno, PH.D.
• Elyse R Resch, MS, RDN, CEDS-S
• Resolution Imaging Medical Corporation
• Resolution Surgical, LLC
• Respiratory Consultants of Santa Monica
• Restorative Residential LLC (Lightfully Behavioral Health)

• Internal Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.