Individual provider Active NPI

Mehul Thakkar, M.D.

  • Internal Medicine Physician
  • Tarzana, CA
National Provider Identifier
1801996640
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C55478 Issued in CA
Practice address
5525 Etiwanda Ave Ste 320
Tarzana, CA 91356-6130
Phone
(818) 774-3838
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C55478 CA Primary

Addresses

Primary practice location

5525 Etiwanda Ave Ste 320
Tarzana, CA 91356-6130

Mailing address

3304 Blue Ridge CT
Westlake Village, CA 91362-3521
Phone (586) 871-7731

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180219002564 CA Practitioner - Internal Medicine 8426092776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

5525 Etiwanda Ave
Suite 320
Tarzana, CA 91356-6130
Phone (818) 774-3839

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C55478CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Feb 1, 2018 Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
William Beaumont Hospital Past Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

18133 Ventura Blvd
Ste 403
Tarzana, CA 91356

5525 Etiwanda Ave
Ste 320
Tarzana, CA 91356
Phone (818) 774-3838

18133 Ventura Blvd
Ste 405
Tarzana, CA 91356
Phone (424) 315-0285

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: mthakkar216772@direct.cshs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1801996640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 BLUE RIDGE CT",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623521",
            "telephone_number": "586-871-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE STE 320",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566130",
            "telephone_number": "818-774-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "MEHUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C55478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.