Individual provider Active NPI

Stephen D Bresnick, MD

  • Plastic Surgery Physician
  • Encino, CA
National Provider Identifier
1831292275
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G074248 Issued in CA
Practice address
16633 Ventura Blvd
Suite 110
Encino, CA 91436-1801
Phone
(818) 981-3333
Fax
(818) 981-0249
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G074248 CA Primary

Addresses

Primary practice location

16633 Ventura Blvd
Suite 110
Encino, CA 91436-1801

Mailing address

16633 Ventura Blvd
Suite 110
Encino, CA 91436-1801
Phone (818) 981-3333

Other identifiers 1

IdentifierTypeStateIssuer
00G742480MedicaidCA

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
I20110106001204 CA Practitioner - Plastic and Reconstructive Surgery 0749479608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of California, San Diego School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16633 Ventura Blvd
Suite 110
Encino, CA 91436-1800

16633 Ventura Blvd
Suite 110
Encino, CA 91436-1801

16633 Ventura Blvd
Suite 110
Encino, CA 91436-1834
Phone (818) 981-3333

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G074248CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen Bresnick, M.D., Inc. CurrentSince Mar 5, 2020 Accepting new patients
Encino Surgicenter a Medical Group PastSince Sep 30, 1993 Accepting new patients

Locations

16633 Ventura Blvd
Ste 110
Encino, CA 91436
Phone (818) 921-3333

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1831292275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16633 VENTURA BLVD",
            "address_2": "SUITE 110",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361801",
            "telephone_number": "818-981-3333",
            "fax_number": "818-981-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16633 VENTURA BLVD",
            "address_2": "SUITE 110",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361801",
            "telephone_number": "818-981-3333",
            "fax_number": "818-981-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESNICK",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G074248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G742480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.