Individual provider Active NPI

Minako Watabe, M.D.

  • Obstetrics & Gynecology Physician
  • Sylmar, CA
National Provider Identifier
1811149131
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A104073 Issued in CA
Practice address
14445 Olive View Dr
Sylmar, CA 91342-1437
Phone
(818) 364-3222
NPI assigned
Oct 17, 2008
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A104073 CA Primary

Addresses

Primary practice location

14445 Olive View Dr
Sylmar, CA 91342-1437

Mailing address

14445 Olive View Drive
Sylmar, CA 91342
Phone (818) 364-3222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address minako.watabe@ventura.cernerdirect.com Direct

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
I20110817000328 CA Practitioner - Obstetrics/Gynecology 7517136013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Icahn School of Medicine at Mount Sinai, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

300 Hillmont Ave
Ventura, CA 93003-1651

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura Current Accepting new patients
County of Ventura CurrentSince Jun 21, 2011 Accepting new patients
County of Ventura CurrentSince Jun 21, 2011 Accepting new patients

Locations

845 N 10th St
Ste 3
Santa Paula, CA 93060
Phone (805) 525-0215

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100

800 S Victoria Ave
#L4640
Ventura, CA 93009

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1811149131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-364-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATABE",
        "first_name": "MINAKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A104073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "minako.watabe@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "14445 Olive View Dr",
            "city": "Sylmar",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913421437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.