Active NPI
Carter Michael Prentice, MD
- Surgery Physician
- Los Angeles, CA
National Provider Identifier
1770231300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 11507
- Practice address
- 757 Westwood PLZ
Los Angeles, CA 90095-5127 - Phone
- (310) 794-7788
- NPI assigned
- Mar 14, 2022
- Last updated
- Dec 3, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 11507 | CA | Primary |
Addresses
Primary practice location
757 Westwood PLZ
Los Angeles, CA 90095-5127
Mailing address
757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (424) 467-5487
Other names 1
- Carter Michael Griest
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231214002716 | CA | Order and Referring Only - General Surgery | 6709235898 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11507 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701561600000",
"number": "1770231300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958358",
"telephone_number": "424-467-5487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900955127",
"telephone_number": "310-794-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENTICE",
"first_name": "CARTER",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-14",
"last_updated": "2023-12-03",
"certification_date": "2023-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "11507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CARTER",
"last_name": "GRIEST",
"middle_name": "MICHAEL",
"code": "1",
"type": "Former Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.