NPIMap

Organization Active NPI

Mid-Valley Pulmonary Medical Group, Inc.

  • Pulmonary Disease Physician
  • Sherman Oaks, CA
National Provider Identifier
1689688335
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
MID-VALLEY PULMONARY MEDICAL GROUP, INC.
Practice address
4955 Van Nuys Blvd
#502
Sherman Oaks, CA 91403-1817
Phone
(818) 325-0200
Fax
(818) 325-0210
NPI assigned
Jul 28, 2006
Last updated
Aug 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Nechemia B Peleg, MDNPI 1437172657
Title
Cfo, VP
Phone
(818) 325-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 0870516 CA

Addresses

Primary practice location

4955 Van Nuys Blvd
#502
Sherman Oaks, CA 91403-1817

Mailing address

4955 Van Nuys Blvd
#502
Sherman Oaks, CA 91403-1817
Phone (818) 325-0200

Other identifiers 1

IdentifierTypeStateIssuer
GR0022520MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613001347 CA Part B Supplier - Clinic/Group Practice 8325029143 Receives reassigned benefits from 26 practitioners
Practice locations: Sherman Oaks, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1689688335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "#502",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031817",
            "telephone_number": "818-325-0200",
            "fax_number": "818-325-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "#502",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031817",
            "telephone_number": "818-325-0200",
            "fax_number": "818-325-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-VALLEY PULMONARY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "PELEG",
        "authorized_official_first_name": "NECHEMIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO, VP",
        "authorized_official_telephone_number": "818-325-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "0870516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0022520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.