NPIMap

Individual provider Active NPI

Michael Dylan Healy, M.D.

  • Nephrology Physician
  • Inglewood, CA
National Provider Identifier
1861495020
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G27842 Issued in CA
Practice address
323 N Prairie Ave
Ste 334
Inglewood, CA 90301-4505
Phone
(310) 674-8600
Fax
(310) 671-9883
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G27842 CA Primary

Addresses

Primary practice location

323 N Prairie Ave
Ste 334
Inglewood, CA 90301-4505

Mailing address

323 N Prairie Ave
Ste 334
Inglewood, CA 90301-4505
Phone (310) 674-8600

Other identifiers 1

IdentifierTypeStateIssuer
00G278420MedicaidCA

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
I20100520000677 CA Practitioner - NephrologyPractitioner - Internal Medicine 0749325579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Saint Louis University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Nephrology Medical GroupGroup PAC ID 8729050174, 3 clinicians

Practice addresses (Care Compare)

323 N Prairie Ave
Suite 334
Inglewood, CA 90301-4502
Phone (310) 674-8600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health System Southern California Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Yep H. Wong, M.D. Inc Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Cedars-Sinai Marina Hospital Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 7

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1861495020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "address_2": "STE 334",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014505",
            "telephone_number": "310-674-8600",
            "fax_number": "310-671-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "address_2": "STE 334",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014505",
            "telephone_number": "310-674-8600",
            "fax_number": "310-671-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEALY",
        "first_name": "MICHAEL",
        "middle_name": "DYLAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G27842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G278420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.