NPIMap

Individual provider Active NPI

Charise Leanne Ivy, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Glendale, CA
National Provider Identifier
1871668293
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A86275 Issued in CA
Practice address
1500 E Chevy Chase Dr Ste 401
Glendale Adventist Medical Center Spine Institute
Glendale, CA 91206-4153
Phone
(818) 863-4451
Fax
(818) 863-4984
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 242320 MA
Physical Medicine & Rehabilitation Physician 208100000X A86275 CA Primary

Addresses

Primary practice location

1500 E Chevy Chase Dr Ste 401
Glendale Adventist Medical Center Spine Institute
Glendale, CA 91206-4153

Mailing address

PO Box 1237
Sierra Madre, CA 91025-4237
Phone (626) 808-5352

Other names 1

  • Charise Leanne Brown Former name

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
I20040818001440 CA Practitioner - Physical Medicine and Rehabilitation 5698748473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1420 S Central Ave
Glendale, CA 91204-2508
Phone (818) 502-1900

Hospital & facility affiliations

  • Cross Care, Inc Home health agency, Los Angeles, CA, CCN 059383
  • Storm Home Health Care, Inc Home health agency, Van Nuys, CA, CCN 753119
  • Arden Home Health Home health agency, Glendale, CA, CCN 553110
  • Three Olives Home Health Corp. Home health agency, Reseda, CA, CCN 757248
  • Lavanda Home Health Care Agency, Inc Home health agency, Burbank, CA, CCN 058334
  • Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471
  • Good Samaritan Hospital Inpatient rehabilitation facility, Los Angeles, CA, CCN 05T471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86275CAMDPhysical Medicine & Rehabilitation Physician
242320MAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivy Medical Associates Inc Physical Medicine & Rehabilitation CurrentSince Dec 29, 2011 Accepting new patients
Algos Inc., a Medical Corporation Past Accepting new patients

Locations

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

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.

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1871668293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1237",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910254237",
            "telephone_number": "626-808-5352",
            "fax_number": "626-797-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E CHEVY CHASE DR STE 401",
            "address_2": "GLENDALE ADVENTIST MEDICAL CENTER SPINE INSTITUTE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064153",
            "telephone_number": "818-863-4451",
            "fax_number": "818-863-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "CHARISE",
        "middle_name": "LEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "242320",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A86275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARISE",
            "last_name": "BROWN",
            "middle_name": "LEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.