Individual provider Active NPI

Chima Sean Nzerem, D.O.

  • Anesthesiology Physician
  • San Bernardino, CA
National Provider Identifier
1821386848
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A13808 Issued in CA
Practice address
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone
(909) 883-8711
NPI assigned
Jul 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A13808 CA Primary

Addresses

Primary practice location

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (714) 347-1010

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
I20150804006295 CA Practitioner - Anesthesiology 4284948282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buena Vista Anesthesia Medical GroupGroup PAC ID 7113975996, 51 clinicians

Practice addresses (Care Compare)

501 S Buena Vista St
Burbank, CA 91505-4866
Phone (818) 843-5111

Hospital & facility affiliations

  • Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235
  • Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13808CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buena Vista Anesthesia Medical Group Anesthesiology CurrentSince Aug 1, 2017 Accepting new patients

Locations

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1821386848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1010",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-883-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NZEREM",
        "first_name": "CHIMA",
        "middle_name": "SEAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A13808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.