NPIMap

Organization Active NPI

Cardiovascular Consultants Medical Group

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1669664090
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR CONSULTANTS MEDICAL GROUP
Practice address
10921 Wilshire Blvd Ste 1205
Los Angeles, CA 90024-4005
Phone
(310) 824-3378
Fax
(310) 208-2870
NPI assigned
Aug 9, 2007
Organization subpart
Yes
Parent organization
CARDIOVASCULAR CONSULTANTS MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Dr. Isaac Wiener, M.D.
Title
Physician / Managing Partner
Phone
(818) 782-5041

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X

Addresses

Primary practice location

10921 Wilshire Blvd Ste 1205
Los Angeles, CA 90024-4005

Mailing address

16542 Ventura Blvd Ste 402
Encino, CA 91436-4562
Phone (818) 782-5041

Other identifiers 2

IdentifierTypeStateIssuer
W119AOtherCAMEDICARE GROUP PROVIDER #
W119OtherCALEGACY NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000844 CA Part B Supplier - Clinic/Group Practice 5991786105 Receives reassigned benefits from 13 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Encino, CA; Los Angeles, CA; Mission Hills, CA; Valencia, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cardiovascular Consultants3 organizations share this tax ID, including this one
Part of
Cardiovascular Consultants

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15243 Vanowen St
Ste 301
Van Nuys, CA 91405
Phone (818) 782-5041

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)…

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1669664090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16542 VENTURA BLVD STE 402",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364562",
            "telephone_number": "818-782-5041",
            "fax_number": "818-205-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 1205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244005",
            "telephone_number": "310-824-3378",
            "fax_number": "310-208-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CONSULTANTS MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARDIOVASCULAR CONSULTANTS MEDICAL GROUP",
        "enumeration_date": "2007-08-09",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "WIENER",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "PHYSICIAN / MANAGING PARTNER",
        "authorized_official_telephone_number": "818-782-5041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER #",
            "identifier": "W119A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY NUMBER",
            "identifier": "W119",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.

Verify at the official NPI Registry.