Active NPI
Nicholas Ullman, MD
- Surgery Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A194213
- Practice address
- 2121 Santa Monica Blvd
Santa Monica, CA 90404-2303 - Phone
- (310) 315-6125
- Fax
- (310) 582-7185
- NPI assigned
- Mar 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | A194213 | CA | Primary |
Addresses
Primary practice location
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Mailing address
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 315-6125
Other practice location 1
601 Elmwood Ave
Box Surg
Rochester, NY 14642-0001
Phone (585) 275-2723
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Univ of Rochester School of Dental Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 829-5511
Hospital & facility affiliations
- Saint John'S Health Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 96.07
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Mastectomy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A194213 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Providence Saint Johns Medical Foundation | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
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 and National Provider Directory roles.
-
- Specialist
- Santa Monica, CA
- NPI 1770093734
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Lancaster, CA
- NPI 1982863783
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1124026273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1760913735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 SANTA MONICA BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042303",
"telephone_number": "310-315-6125",
"fax_number": "310-582-7185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 SANTA MONICA BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042303",
"telephone_number": "310-315-6125",
"fax_number": "310-582-7185"
}
],
"practiceLocations": [
{
"address_1": "601 Elmwood Ave",
"address_2": "BOX SURG",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "NY",
"postal_code": "146420001",
"country_code": "US",
"telephone_number": "585-275-2723",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ULLMAN",
"first_name": "NICHOLAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-22",
"last_updated": "2024-12-18",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A194213",
"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 Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.