Individual provider Active NPI

Aleksey Korolyov

  • Hospitalist Physician
  • Santa Monica, CA
National Provider Identifier
1891055349
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A141941 Issued in CA
Practice address
1250 16TH St # C2304
Santa Monica, CA 90404-1249
Phone
(310) 319-4698
Fax
(310) 319-4908
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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 A141941 CA
Hospitalist Physician 208M00000X A141941 CA Primary

Addresses

Primary practice location

1250 16TH St # C2304
Santa Monica, CA 90404-1249

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

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
I20170711001831 CA Practitioner - Internal Medicine 4688943483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Davis School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1250 16TH St
Suite C2304
Santa Monica, CA 90404-1249
Phone (310) 319-4698

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141941CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
The Regents of the University of California CurrentSince Jul 1, 2017 Accepting new patients
UCLA Medical Group Internal Medicine Past Accepting new patients

Locations

File 55737
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1250 16th St
#C2304
Santa Monica, CA 90404

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

1250 16th St
Ste C2304
Santa Monica, CA 90404
Phone (424) 259-6000

Interoperability endpoints

  • Direct secure messaging: akorolyov302618@direct.uclahealth.org

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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1891055349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 16TH ST # C2304",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "310-319-4698",
            "fax_number": "310-319-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLYOV",
        "first_name": "ALEKSEY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A141941",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A141941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.