Organization Active NPI

Womens Medical Group of Santa Monica

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Santa Monica, CA
National Provider Identifier
1861617896
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X
Legal business name
WOMENS MEDICAL GROUP OF SANTA MONICA
Practice address
1441 Broadway
Santa Monica, CA 90404-2711
Phone
(310) 264-1777
Fax
(310) 264-1787
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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

Authorized official

Name
Allison M Leong, M.D.NPI 1952440562
Title
Partner
Phone
(310) 264-1777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VH0002X Primary

Addresses

Primary practice location

1441 Broadway
Santa Monica, CA 90404-2711

Mailing address

1441 Broadway
Santa Monica, CA 90404-2711
Phone (310) 264-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120518000433 CA Part B Supplier - Clinic/Group Practice 2860655412 Receives reassigned benefits from 2 practitioners
Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Locations

2121 Wilshire Blvd
Ste 303
Santa Monica, CA 90403
Phone (310) 264-1777

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1861617896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 BROADWAY",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042711",
            "telephone_number": "310-264-1777",
            "fax_number": "310-264-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 BROADWAY",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042711",
            "telephone_number": "310-264-1777",
            "fax_number": "310-264-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMENS MEDICAL GROUP OF SANTA MONICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "LEONG",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "310-264-1777",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.