Individual provider Active NPI

Pradeep Kumar Selvan, M.D.

  • Neurological Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1871938092
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A149381 Issued in CA
Practice address
1520 San Pablo St Ste 3800
Los Angeles, CA 90033-5328
Phone
(323) 442-5720
NPI assigned
May 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A149381 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 3800
Los Angeles, CA 90033-5328

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5720

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pradeep.selvan@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20190823001910 CA Practitioner - Neurosurgery 1254669518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Temple University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (213) 674-9390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149381CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2019 Accepting new patients
Selvan MD a Professional Medical Corporation Neurological Surgery CurrentSince Aug 15, 2021 Accepting new patients
Usc Care Medical Group, Inc Neurological Surgery CurrentSince Jun 1, 2019 Accepting new patients

Locations

17525 Ventura Blvd
Ste 210
Encino, CA 91316
Phone (818) 501-8743

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

1520 San Pablo St
Ste 3800
Los Angeles, CA 90033
Phone (323) 442-5720

3705 W Pico Blvd
Los Angeles, CA 90019
Phone (310) 651-4279

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

Interoperability endpoints

  • Direct secure messaging: pradeep.selvan@direct.usc.edu

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.

Hospital & facility affiliations 2

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": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1871938092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 3800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335328",
            "telephone_number": "323-442-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVAN",
        "first_name": "PRADEEP",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A149381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pradeep.selvan@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 3800",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.