Individual provider Active NPI

Harris Newmark III, M.D.

  • Specialist
  • Pacific Palisades, CA
National Provider Identifier
1730139148
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G170420 Issued in CA
Practice address
227 Toyopa Dr
Pacific Palisades, CA 90272-4463
Phone
(310) 573-9113
Fax
(310) 454-6372
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G170420 CA Primary

Addresses

Primary practice location

227 Toyopa Dr
Pacific Palisades, CA 90272-4463

Mailing address

227 Toyopa Dr
Pacific Palisades, CA 90272-4463
Phone (310) 573-9113

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
I20031105000839 CA Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 9931012036 Practice locations: Reseda, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G170420CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaid Gorban CurrentSince Oct 1, 2013 Accepting new patients
DLS Medical Services Inc CurrentSince Nov 2, 2015 Accepting new patients
Magnolia Imaging Medical Group, Inc. Past Accepting new patients
Natalie Beketova PastSince Mar 29, 2013 Accepting new patients
Dyan M. Cole MD, Inc Past Accepting new patients
Royal National Medical Group Inc. Past Accepting new patients
F&M Radiology Medical Center Inc Past Accepting new patients
Arts Imaging Center Inc Past Accepting new patients

Locations

18747 Sherman Way
Ste 216
Reseda, CA 91335
Phone (310) 279-6973

Organizations & group practices 8

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1730139148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 TOYOPA DR",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724463",
            "telephone_number": "310-573-9113",
            "fax_number": "310-454-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 TOYOPA DR",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724463",
            "telephone_number": "310-573-9113",
            "fax_number": "310-454-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMARK",
        "first_name": "HARRIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G170420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

Verify at the official NPI Registry.