NPIMap

Individual provider Active NPI

Stuart E Braverman, MD

  • Vascular & Interventional Radiology Physician
  • Santa Barbara, CA
National Provider Identifier
1811940901
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
G61296 Issued in CA
Practice address
Pueblo at Bath St
Santa Barbara, CA 93102-0689
Phone
(805) 569-7279
Fax
(805) 569-8279
NPI assigned
May 18, 2006
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G61296 CA
Vascular & Interventional Radiology Physician 2085R0204X G61296 CA Primary

Addresses

Primary practice location

Pueblo at Bath St
Santa Barbara, CA 93102-0689

Mailing address

PO Box 4219
Orange, CA 92863-4219
Phone (800) 984-7070

Other identifiers 4

IdentifierTypeStateIssuer
050396CF30626OtherTRAILBLAZER
00G612960OtherCABLUE SHIELD OF CA
P00324976OtherRAILROAD MEDICARE
00G612960MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000496 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 4183519358 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of California, San Diego School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
California Managed Imaging Medical Group IncGroup PAC ID 9436229887, 76 clinicians
Santa Barbara Radiology Medical Group, Inc.Group PAC ID 6800872953, 9 clinicians

Practice addresses (Care Compare)

2309 Antonio Ave
Camarillo, CA 93010-1414
Phone (805) 389-5655

351 S Patterson Ave
Santa Barbara, CA 93111-2403
Phone (805) 681-6406

400 W Pueblo St
Santa Barbara, CA 93105-4353
Phone (805) 569-7279

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61296CAMDGeneral Practice Dentistry
G61296CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara Radiology Medical Group Inc Diagnostic Radiology CurrentSince Jun 5, 2006 Accepting new patients
Sansum Clinic CurrentSince Jul 1, 1994 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Jul 1, 1994 Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Sansum Clinic Past Accepting new patients
Goleta Valley Cottage Hospital Past Accepting new patients
Pueblo Radiology Medical Group Inc Diagnostic Radiology Past Accepting new patients
Santa Ynez Valley Cottage Hospital, Inc Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279

168 N Brent St
Ste 503
Ventura, CA 93003
Phone (805) 653-0101

Organizations & group practices 10

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 5

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1811940901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4219",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928634219",
            "telephone_number": "800-984-7070",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PUEBLO AT BATH ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931020689",
            "telephone_number": "805-569-7279",
            "fax_number": "805-569-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "STUART",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G61296",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "G61296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAILBLAZER",
            "identifier": "050396CF30626",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00G612960",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00324976",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G612960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.