Organization Active NPI

Ethan J. Baughman, M.D. Inc., a Medical Corporation

  • Plastic and Reconstructive Surgery Physician
  • Westlake Village, CA
National Provider Identifier
1770050460
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
ETHAN J. BAUGHMAN, M.D. INC., A MEDICAL CORPORATION
Practice address
32144 Agoura Rd Ste 220
Westlake Village, CA 91361-4057
Phone
(805) 409-7537
Fax
(310) 363-7610
NPI assigned
Oct 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Dr. Ethan James Baughman, MDNPI 1619316783
Title
Owner
Phone
(972) 413-9683

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
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

32144 Agoura Rd Ste 220
Westlake Village, CA 91361-4057

Mailing address

32144 Agoura Rd Ste 220
Westlake Village, CA 91361-4057
Phone (805) 409-7537

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191025002225 CA Part B Supplier - Clinic/Group Practice 8325370232 Receives reassigned benefits from 1 practitioner
Practice locations: Thousand Oaks, CA; West Hills, CA; Westlake Village, CA

National Provider Directory

National Provider Directory

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": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1770050460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD STE 220",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614057",
            "telephone_number": "805-409-7537",
            "fax_number": "310-363-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD STE 220",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614057",
            "telephone_number": "805-409-7537",
            "fax_number": "310-363-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHAN J. BAUGHMAN, M.D. INC., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "BAUGHMAN",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-413-9683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.