Individual provider Active NPI

Naveed Wagle, MD

  • Neurology Physician
  • Santa Monica, CA
National Provider Identifier
1871754655
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A100135 Issued in CA
Practice address
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone
(310) 829-8265
NPI assigned
Jun 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A100135 CA Primary

Addresses

Primary practice location

2121 Santa Monica Blvd
Santa Monica, CA 90404

Mailing address

2020 Santa Monica Blvd
Santa Monica, CA 90404-2023
Phone (310) 582-7313

Other practice location 1

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 829-8265

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nwagle389997@oc.providencedirect.org
Direct Messaging Address nwagle389997@oc.providencedirect.org

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
I20090716000381 CA Practitioner - Neurology 9931251378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12121 Santa Monica Blvd
Los Angeles, CA 90025-2515
Phone (310) 826-0821

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100135CAMDEndodontist
A100135CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Oct 1, 2011 Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Aug 1, 2019 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Oct 1, 2011 Accepting new patients
Pacific Hearing , Inc Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Saint John's Health Clinic Past Accepting new patients
Pacific Hearing & Balance., Inc Past Accepting new patients

Locations

501 S Buena Vista St
#1
Burbank, CA 91505
Phone (818) 847-4145

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1441 Eastlake Ave
Ste 3440
Los Angeles, CA 90089
Phone (323) 865-3956

1441 Eastlake Ave
Ste G306
Los Angeles, CA 90089

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

1301 20th St
Ste 300
Santa Monica, CA 90404
Phone (310) 829-7792

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

1301 20th St
Ste 150
Santa Monica, CA 90404
Phone (310) 582-7641

1301 20th St
Ste 540
Santa Monica, CA 90404
Phone (310) 582-7612

5215 Torrance Blvd
Ste 300
Torrance, CA 90503
Phone (310) 303-6126

4201 Torrance Blvd
Ste 520
Torrance, CA 90503
Phone (310) 274-5372

12121 Santa Monica Blvd
West Los Angeles, CA 90025
Phone (310) 826-0821

11645 Wilshire Blvd
Ste 600
West Los Angeles, CA 90025
Phone (310) 477-5558

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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 3

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1871754655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042023",
            "telephone_number": "310-582-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-829-8265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "90404",
            "country_code": "US",
            "telephone_number": "310-829-8265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGLE",
        "first_name": "NAVEED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A100135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nwagle389997@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5215 Torrance Blvd Ste 300",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905034009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nwagle389997@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2121 Santa Monica Blvd",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "90404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.