Individual provider Active NPI

Michael Reynard, MD

  • Ophthalmology Physician
  • Santa Monica, CA
National Provider Identifier
1851478481
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G40986 Issued in CA
Practice address
1301 20TH St Ste 260
Santa Monica, CA 90404-2052
Phone
(310) 453-0551
Fax
(310) 315-0133
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G40986 CA Primary

Addresses

Primary practice location

1301 20TH St Ste 260
Santa Monica, CA 90404-2052

Mailing address

1301 20TH St Ste 260
Santa Monica, CA 90404-2052
Phone (310) 453-0551

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
I20081114000194 CA Practitioner - Ophthalmology 4688734163 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Columbia University College of Physicians and Surgeons, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venice Family ClinicGroup PAC ID 2264339126, shared by 17 NPIs, 101 clinicians

Practice addresses (Care Compare)

604 Rose Ave
Venice, CA 90291-2767
Phone (310) 664-7901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40986CAMDMarriage & Family Therapist
G40986CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Siegel MD Inc Ophthalmology Past Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1851478481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 260",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042052",
            "telephone_number": "310-453-0551",
            "fax_number": "310-315-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 260",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042052",
            "telephone_number": "310-453-0551",
            "fax_number": "310-315-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNARD",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G40986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.