Individual provider Active NPI

Andrea Birnbaum, MD

  • Psychiatry Physician
  • Sylmar, CA
National Provider Identifier
1790263101
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR.0068980 Issued in CO
Practice address
14445 Olive View Dr # H1
Sylmar, CA 91342-1437
Phone
(747) 210-3613
Fax
(747) 210-4755
NPI assigned
Jul 30, 2018
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 317211 NY
Psychiatry Physician 2084P0800X DR.0068980 CO Primary

Addresses

Primary practice location

14445 Olive View Dr # H1
Sylmar, CA 91342-1437

Mailing address

14445 Olive View Dr # H1
Sylmar, CA 91342-1437
Phone (747) 210-3613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221103002077 MA Practitioner - Psychiatry 2961881545 Reassigns benefits to 2 organizations
I20230912003374 CA Practitioner - Psychiatry 2961881545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 16, 2023 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 16, 2023 Accepting new patients

Locations

1224 Vine St
Los Angeles, CA 90038
Phone (323) 769-6100

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

14445 Olive View Dr
#H1
Sylmar, CA 91342
Phone (747) 210-3343

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1790263101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR # H1",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "747-210-3613",
            "fax_number": "747-210-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR # H1",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "747-210-3613",
            "fax_number": "747-210-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRNBAUM",
        "first_name": "ANDREA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "317211",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0068980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.