Individual provider Active NPI

Evan Walgama, M.D.

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1750609285
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A136819 Issued in CA
Practice address
8635 W 3Rd St Ste 590W
Los Angeles, CA 90048-6163
Phone
(310) 423-1220
NPI assigned
May 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X A136819 CA
Otolaryngology Physician 207Y00000X A136819 CA Primary

Addresses

Primary practice location

8635 W 3Rd St Ste 590W
Los Angeles, CA 90048-6163

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

2125 Arizona Ave
Santa Monica, CA 90404-1337
Phone (910) 829-8701

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ewalgama1747626@oc.providencedirect.org

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
I20150718000144 CA Practitioner - Otolaryngology 9436462538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Southwestern Medical School at Dallas, 2010
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)

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Cedar-Sinai Marina del Rey Hospital Hospital, Marina del Rey, CA, CCN 050740
  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A136819CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Jul 19, 2021 Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Jul 19, 2021 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Ut MD Anderson Cancer Center Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients

Locations

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

2125 Arizona Ave
Santa Monica, CA 90404
Phone (310) 582-7450

2125 Arizona Ave
Fl 1
Santa Monica, CA 90404
Phone (310) 829-8701

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

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 577-5505

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ewalgama209126@direct.cshs.org

Organizations & group practices 10

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": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1750609285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 590W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486163",
            "telephone_number": "310-423-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2125 Arizona Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041337",
            "country_code": "US",
            "telephone_number": "910-829-8701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALGAMA",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-07",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "A136819",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A136819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewalgama1747626@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2125 Arizona Ave Fl 1",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904041337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.