Individual provider Active NPI

Dina K Kiseleva, M.D.

  • Obstetrics & Gynecology Physician
  • Santa Monica, CA
National Provider Identifier
1871785501
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A102707 Issued in CA
Practice address
2001 Santa Monica Blvd Ste 970W
Santa Monica, CA 90404-2199
Phone
(310) 829-7878
Fax
(310) 453-5586
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A102707 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd Ste 970W
Santa Monica, CA 90404-2199

Mailing address

2001 Santa Monica Blvd
Suite 970W
Santa Monica, CA 90404-2102
Phone (310) 829-7878

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dkiseleva473422@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
I20120525000043 CA Practitioner - Obstetrics/Gynecology 2466615604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Albany Medical College of Union University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 Santa Monica Blvd
Suite 970W
Santa Monica, CA 90404-2199
Phone (310) 829-7878

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102707CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frumovitz, Matsunaga, Daly, Ross, Thordarson, Vogel, MD's - a Med Corp CurrentSince Mar 21, 2012 Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Jul 1, 2018 Accepting new patients
The Regents of the University of California Past Accepting new patients
Providence Saint John's Health Center Past Accepting new patients

Locations

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

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

2001 Santa Monica Blvd
Ste 970W
Santa Monica, CA 90404
Phone (310) 829-7272

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

2001 Santa Monica Blvd
Ste 870W
Santa Monica, CA 90404
Phone (310) 829-1703

2001 Santa Monica Blvd
Ste 970
Santa Monica, CA 90404
Phone (310) 829-7878

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dkiseleva473422@oc.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1871785501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD",
            "address_2": "SUITE 970W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042102",
            "telephone_number": "310-829-7878",
            "fax_number": "310-453-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 970W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042199",
            "telephone_number": "310-829-7878",
            "fax_number": "310-453-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISELEVA",
        "first_name": "DINA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A102707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkiseleva473422@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2001 Santa Monica Blvd Ste 970W",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042199",
            "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.