Individual provider Active NPI

Eli Edward Hendel, MD

  • Pulmonary Disease Physician
  • Glendale, CA
National Provider Identifier
1871552661
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A36257 Issued in CA
Practice address
1500 South Central Ave
Suite 117
Glendale, CA 91204
Phone
(818) 500-9545
Fax
(818) 500-7414
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A36257 CA
Pulmonary Disease Physician 207RP1001X A36257 CA Primary

Addresses

Primary practice location

1500 South Central Ave
Suite 117
Glendale, CA 91204

Mailing address

PO Box 16271
Encino, CA 91416-6271
Phone (818) 788-6172

Other identifiers 1

IdentifierTypeStateIssuer
00A362570MedicaidCA

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
I20050906000965 CA Practitioner - Pulmonary Disease 0345272860 Practice locations: Glendale, CA

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1500 S Central Ave
Suite 117
Glendale, CA 91204-2580
Phone (818) 500-9545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A36257CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breathe Diagnostics, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Astrana Care Hospitalists, a Medical Corporation PastSince Jan 19, 2020 Accepting new patients
Eli E. Hendel, MD., a Corporation Pulmonary Disease PastSince Jan 1, 1990 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shant Home Health Care, Inc.Van Nuys, CA, CCN 058399 Home health agency Corporate Director Feb 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1871552661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16271",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914166271",
            "telephone_number": "818-788-6172",
            "fax_number": "818-788-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SOUTH CENTRAL AVE",
            "address_2": "SUITE 117",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91204",
            "telephone_number": "818-500-9545",
            "fax_number": "818-500-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDEL",
        "first_name": "ELI",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A36257",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A36257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A362570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.