Organization Active NPI

Cynthia Boxrud MD a Medical Corporation

  • Ophthalmic Technician/Technologist
  • Santa Monica, CA
National Provider Identifier
1750697736
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
A50569 Issued in CA
Legal business name
CYNTHIA BOXRUD MD A MEDICAL CORPORATION
Practice address
2021 Santa Monica Blvd
700E
Santa Monica, CA 90404-2208
Phone
(310) 829-9060
Fax
(310) 829-9015
NPI assigned
Aug 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Dr. Cynthia A. Boxrud, M.D.NPI 1902950405
Title
Medical Director
Phone
(310) 829-9060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X A50569 CA Primary

Addresses

Primary practice location

2021 Santa Monica Blvd
700E
Santa Monica, CA 90404-2208

Mailing address

2021 Santa Monica Blvd
700E
Santa Monica, CA 90404-2208
Phone (310) 829-9060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120411000566 CA Part B Supplier - Clinic/Group Practice 4284895673 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Locations

2021 Santa Monica Blvd
Ste 700E
Santa Monica, CA 90404
Phone (310) 829-9060

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1750697736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "700E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-9060",
            "fax_number": "310-829-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "700E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-829-9060",
            "fax_number": "310-829-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA BOXRUD MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "BOXRUD",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-829-9060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "CA",
            "license": "A50569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.