Individual provider Active NPI

Stefanie Kamen, M.D.

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1700200557
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A126171 Issued in CA
Practice address
4650 W Sunset Blvd # 68
Los Angeles, CA 90027-6062
Phone
(323) 361-2122
Fax
(323) 361-7926
NPI assigned
Feb 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A126171 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd # 68
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd # 68
Los Angeles, CA 90027-6062
Phone (323) 361-2122

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
I20140930003021 CA Practitioner - Pediatric Medicine 1658591342 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A126171CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Valley Health Corporation CurrentSince Mar 11, 2017 Accepting new patients
Valley Community Healthcare CurrentSince Jul 28, 2014 Accepting new patients
Northeast Valley Health Corporation CurrentSince Mar 11, 2017 Accepting new patients
Valley Community Healthcare CurrentSince Jul 28, 2014 Accepting new patients
Northeast Valley Health Corporation Current Accepting new patients

Locations

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

6801 Coldwater Canyon Ave
North Hollywood, CA 91605
Phone (818) 301-6307

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: stefanie.kamen.p1@direct.nevhc.nextgenshare.com

Organizations & group practices 5

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": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1700200557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 68",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2122",
            "fax_number": "323-361-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 68",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2122",
            "fax_number": "323-361-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMEN",
        "first_name": "STEFANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A126171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.