Individual provider Active NPI

Charles Vainder, MD

  • Dermatology Physician
  • Glendale, CA
National Provider Identifier
1700296829
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A168465 Issued in CA
Practice address
1818 Verdugo Blvd Ste 304
Glendale, CA 91208-1444
Phone
(748) 588-8588
NPI assigned
Apr 28, 2014
Last updated
Feb 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A168465 CA Primary

Addresses

Primary practice location

1818 Verdugo Blvd Ste 304
Glendale, CA 91208-1444

Mailing address

1812 W Burbank Blvd Ste 1046
Burbank, CA 91506-1315
Phone (847) 858-8588

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
I20200611000907 CA Practitioner - Dermatology 8820369325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin and Beauty Center IncGroup PAC ID 8628170347, 34 clinicians

Practice addresses (Care Compare)

2720 W Magnolia Blvd
Burbank, CA 91505-3034
Phone (818) 842-8000

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1196
Removal of skin cancer1-10
Removal or shaving of skin growth1-10
Skin biopsy388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168465CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin and Beauty Center Inc Dermatology CurrentSince Jun 15, 2020 Accepting new patients
Northridge Dermatology Associates Medical Group Inc Dermatology Current Accepting new patients

Locations

191 S Buena Vista St
Ste 475
Burbank, CA 91505
Phone (818) 322-0126

2720 W Magnolia Blvd
Burbank, CA 91505
Phone (818) 842-8000

1818 Verdugo Blvd
Ste 304
Glendale, CA 91208
Phone (818) 790-3588

9535 Reseda Blvd
Ste 304
Northridge, CA 91324
Phone (818) 886-3884

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cvainder@dcm-ca.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1700296829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 W BURBANK BLVD STE 1046",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061315",
            "telephone_number": "847-858-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD STE 304",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081444",
            "telephone_number": "748-588-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAINDER",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A168465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.