Active NPI
Thomas Karl Ciesla, MD
- Psychiatry Physician
- Santa Monica, CA
National Provider Identifier
1780683169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G9703
- Practice address
- 1301 20TH St
Ste 212
Santa Monica, CA 90404-2050 - Phone
- (310) 315-0300
- Fax
- (310) 315-0302
- NPI assigned
- Jul 19, 2005
- Last updated
- Jan 9, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G9703 | CA | Primary |
Addresses
Primary practice location
1301 20TH St
Ste 212
Santa Monica, CA 90404-2050
Mailing address
1301 20TH St
Ste 212
Santa Monica, CA 90404-2050
Phone (310) 315-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061432 | Other | CA | MANAGED HEALTH NETWORK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 31, 2021 through Dec 31, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G9703 | CA | MD | Psychiatry Physician |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Santa Monica, CA
- NPI 1265825350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262995200000",
"number": "1780683169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 20TH ST",
"address_2": "STE 212",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042050",
"telephone_number": "310-315-0300",
"fax_number": "310-315-0302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 20TH ST",
"address_2": "STE 212",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042050",
"telephone_number": "310-315-0300",
"fax_number": "310-315-0302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIESLA",
"first_name": "THOMAS",
"middle_name": "KARL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2010-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G9703",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "061432",
"state": "CA"
}
],
"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 Jan 9, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.