Individual provider Active NPI

Angelika Buddeberg, MD

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1891721718
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G81245 Issued in CA
Practice address
901 Wilshire Blvd FL 2
Santa Monica, CA 90401-1854
Phone
(310) 829-8908
Fax
(424) 212-5931
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G81245 CA Primary

Addresses

Primary practice location

901 Wilshire Blvd FL 2
Santa Monica, CA 90401-1854

Mailing address

901 Wilshire Blvd FL 2
Santa Monica, CA 90401-1854
Phone (310) 829-8908

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abuddeberg472936@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
I20110315000254 CA Practitioner - Family Practice 1254513062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Un of California, Irvine, College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

901 Wilshire Blvd
FL 2
Santa Monica, CA 90401-1854
Phone (310) 829-8908

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G81245CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
The Regents of the University of California Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Santa Monica Bay Area Physicians Family Medicine 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

901 Wilshire Blvd
Fl 2
Santa Monica, CA 90401
Phone (310) 829-8908

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

901 Wilshire Blvd
Fl 1
Santa Monica, CA 90401
Phone (310) 829-8441

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: abuddeberg472936@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 and National Provider Directory roles.

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1891721718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WILSHIRE BLVD FL 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011854",
            "telephone_number": "310-829-8908",
            "fax_number": "424-212-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WILSHIRE BLVD FL 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011854",
            "telephone_number": "310-829-8908",
            "fax_number": "424-212-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDDEBERG",
        "first_name": "ANGELIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G81245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abuddeberg472936@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "901 Wilshire Blvd Fl 2",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904011854",
            "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.