Individual provider Active NPI

Martin D. Levine, M.D.

  • Neurology Physician
  • Van Nuys, CA
National Provider Identifier
1669470860
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G21066 Issued in CA
Practice address
6815 Noble Ave Ste 105
Van Nuys, CA 91405-6514
Phone
(818) 781-6684
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G021066 CA
Neurology Physician 2084N0400X G21066 CA Primary

Addresses

Primary practice location

6815 Noble Ave Ste 105
Van Nuys, CA 91405-6514

Mailing address

PO Box 5486
Orange, CA 92863-5486
Phone (818) 550-0900

Other practice location 1

5901 W Olympic Blvd Ste 204
Los Angeles, CA 90036-4663
Phone (323) 938-2300

Other identifiers 1

IdentifierTypeStateIssuer
00G210660MedicaidCA

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
I20040109000746 CA Practitioner - Neurology 7315847001 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G021066CAMDSpecialist
G21066CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Encino Neurological Medical Group Specialist CurrentSince Jan 1, 1973 Accepting new patients
Conservative Care Specialists Medical Group Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

16311 Ventura Blvd
Ste 680
Encino, CA 91436
Phone (310) 246-0702

5901 W Olympic Blvd
Ste 204
Los Angeles, CA 90036
Phone (323) 938-2300

6815 Noble Ave
Ste 105
Van Nuys, CA 91405
Phone (818) 781-6684

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1669470860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5486",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635486",
            "telephone_number": "818-550-0900",
            "fax_number": "818-550-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 NOBLE AVE STE 105",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914056514",
            "telephone_number": "818-781-6684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 W Olympic Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900364663",
            "country_code": "US",
            "telephone_number": "323-938-2300",
            "fax_number": "323-938-2330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "MARTIN",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G021066",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G21066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G210660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.