Individual provider Active NPI

Peter C Pelikan, M.D.

  • Interventional Cardiology Physician
  • Santa Monica, CA
National Provider Identifier
1710984331
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
G43904 Issued in CA
Practice address
2001 Santa Monica Blvd Ste 280W
Santa Monica, CA 90404-2172
Phone
(310) 829-7678
Fax
(310) 829-6889
NPI assigned
Jun 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G43904 CA
Interventional Cardiology Physician 207RI0011X G43904 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd Ste 280W
Santa Monica, CA 90404-2172

Mailing address

2001 Santa Monica Blvd
Suite 280W
Santa Monica, CA 90404-2102
Phone (310) 829-7678

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
I20100218000726 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5294879904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Harvard Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

2001 Santa Monica Blvd
Suite 560W
Santa Monica, CA 90404-2182
Phone (310) 582-7900

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G43904CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Jul 1, 2018 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 1, 2025 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 1, 2025 Accepting new patients
The Regents of the University of California Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

2001 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 829-3401

2001 Santa Monica Blvd
Ste 280W
Santa Monica, CA 90404
Phone (310) 829-7678

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2001 Santa Monica Blvd
Ste 560W
Santa Monica, CA 90404
Phone (310) 453-5654

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2001 Santa Monica Blvd
Ste 360W
Santa Monica, CA 90404
Phone (310) 453-1871

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ppelikan514185@direct.cshs.org
  • Direct secure messaging: ppelikan473236@oc.providencedirect.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1710984331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "SUITE 280W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-829-7678",
            "fax_number": "310-829-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 280W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042172",
            "telephone_number": "310-829-7678",
            "fax_number": "310-829-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELIKAN",
        "first_name": "PETER",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G43904",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G43904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.