Philip H Conwisar, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G74333 Issued in CA

Practice address

4835 Van Nuys Blvd Ste 210
Sherman Oaks, CA 91403-2156

Phone

(818) 784-1354

Fax

(818) 784-5705

NPI assigned

Aug 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Orthopedic Surgery

Education

R Franklin University of Med & Sci/Chicago Medical School, 1987

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

Practice roles

Locations

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.

• Philip Conwisar MD Inc.

  dba Valley Care Center

  • Orthopaedic Surgery Physician
  • Sherman Oaks, CA
  • NPI 1184907123
  Medicare reassignment NPD Authorized official
• Providence Health System - Southern California

  dba Providence Saint Joseph Medical Center

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1699883926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD STE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032156",
            "telephone_number": "818-784-1354",
            "fax_number": "818-784-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 VAN NUYS BLVD STE 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032156",
            "telephone_number": "818-784-1354",
            "fax_number": "818-784-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWISAR",
        "first_name": "PHILIP",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G74333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G743330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Connelly
• Sharee Nicole Conrad, LA.C
• Esli Constantino
• Marco Antonio Contreras Gomez
• Karen B Conway, PH.D.
• Dana Annette Cook, L.C.S.W.
• Joshua Cook, PTA
• Stephen Franklin Cooper, M.D.
• Alexandra Ruth Cooperman, LCSW
• Sheila Brosman Cooperr, LMFT

• Orthopaedic Surgery Physician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.