Alyssa T Watanabe, MD

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

G63862 Issued in CA

Practice address

1500 San Pablo St FL 2
Los Angeles, CA 90033-5313

Phone

(323) 442-8541

NPI assigned

Dec 15, 2005

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alyssa T Watanabe Look Former name

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

Specialty

Diagnostic Radiology

Education

University of California, San Francisco School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Bedford Breast Center IncGroup PAC ID 5395160295, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: awatanabe33382@scrippshlth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bedford Breast Center, Inc

  • Multi-Specialty Clinic/Center
  • Beverly Hills, CA
  • NPI 1760878367
  Medicare reassignment Care Compare group NPD
• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment Care Compare group NPD
• Newport Diagnostic Radiology, Inc

  • Diagnostic Radiology Physician
  • Newport Beach, CA
  • NPI 1134345473
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306

  Diagnostic Radiology

  Medicare reassignment NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment
• Central Medical Center Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1497928360
  Medicare reassignment
• Pronet Imaging Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1528099488
  Medicare reassignment
• San Fernando Valley Interventional Radiology and Imaging Center

  • Vascular-Interventional Technology Radiologic Technologist
  • Encino, CA
  • NPI 1942350889
  Medicare reassignment
• North Oc Imaging JV, LLC

  • Radiology Clinic/Center
  • Chino Hills, CA
  • NPI 1376209940
  NPD
• North Oc Imaging JV, LLC

  • Radiology Clinic/Center
  • Irvine, CA
  • NPI 1952026643
  NPD
• Prohealth Partners a Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Torrance, CA
  • NPI 1356882435
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1780660472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31399",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310399",
            "telephone_number": "323-442-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "ALYSSA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "G63862",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G63862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "WATANABE LOOK",
            "middle_name": "T",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abram Wassily, MD
• Elise Wasson, B.S.
• Sophie Wasson
• Yuko Watabe, PH.D.
• Airi Watanabe
• Colin Tsukio Watanabe, MD
• Frederick D. Watanabe, MD
• Hideaki Watanabe, M.D.
• Hitomi Watanabe
• Keith Takashi Watanabe, DDS

• Neuroradiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neuroradiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.

Verify at the official NPI Registry.