Individual provider Active NPI

Phillip Andrew Musikanth, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1760495741
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A50223 Issued in CA
Practice address
5901 W Olympic Blvd
Ste 401
Los Angeles, CA 90036-4667
Phone
(323) 954-1073
Fax
(323) 954-1081
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A50223 CA
Internal Medicine Physician 207R00000X A50223 CA Primary

Addresses

Primary practice location

5901 W Olympic Blvd
Ste 401
Los Angeles, CA 90036-4667

Mailing address

8033 Sunset Blvd
1014
Los Angeles, CA 90046-2401
Phone (323) 954-1073

Other identifiers 1

IdentifierTypeStateIssuer
00A502230MedicaidCA

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
I20050414001205 CA Practitioner - Internal MedicinePractitioner - General Surgery 8628015237

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50223CAMDSpecialist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1760495741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8033 SUNSET BLVD",
            "address_2": "1014",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900462401",
            "telephone_number": "323-954-1073",
            "fax_number": "323-954-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W OLYMPIC BLVD",
            "address_2": "STE 401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364667",
            "telephone_number": "323-954-1073",
            "fax_number": "323-954-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSIKANTH",
        "first_name": "PHILLIP",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A50223",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A502230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.