Individual provider Active NPI

Gregg Curtis Fonarow, MD

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1750316402
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G64544 Issued in CA
Practice address
200 Medical Plaza
#214,365,530,420,120
Los Angeles, CA 90095-3075
Phone
(310) 825-8811
NPI assigned
Jul 11, 2006
Last updated
Jun 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G64544 CA Primary

Addresses

Primary practice location

200 Medical Plaza
#214,365,530,420,120
Los Angeles, CA 90095-3075

Mailing address

5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 825-8816

Other identifiers 1

IdentifierTypeStateIssuer
00G645440MedicaidCA

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
I20120113000459 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0446427421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of California, Geffen School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2020 Santa Monica Blvd
Santa Monica, CA 90404-2023
Phone (310) 458-2381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64544CAMDPharmacist
G64544CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Cardiovascular Disease CurrentSince Jul 1, 1993 Accepting new patients
The Regents of the University of California CurrentSince Jul 1, 1993 Accepting new patients
UCLA Medical Group Cardiovascular Disease Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

200 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-6688

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 458-2381

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: gfonarow59110@direct.uclahealth.org

Organizations & group practices 4

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.

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1750316402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-825-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "#214,365,530,420,120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONAROW",
        "first_name": "GREGG",
        "middle_name": "CURTIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G64544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G645440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.