NPIMap

Organization Active NPI

Long Beach Neurological Medical Group, Inc.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Long Beach, CA
National Provider Identifier
1891898862
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
G32989 Issued in CA
Legal business name
LONG BEACH NEUROLOGICAL MEDICAL GROUP, INC.
Practice address
2880 Atlantic Ave
Suite 260
Long Beach, CA 90806-1714
Phone
(562) 426-3319
Fax
(562) 490-3584
NPI assigned
Sep 6, 2006
Last updated
Oct 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Perry Robert Lubens, M.D.NPI 1659385664
Title
Owner
Phone
(562) 426-3319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X G32989 CA Primary

Addresses

Primary practice location

2880 Atlantic Ave
Suite 260
Long Beach, CA 90806-1714

Mailing address

PO Box 91567
Long Beach, CA 90809-1567
Phone (562) 225-0178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090116000314 CA Part B Supplier - Clinic/Group Practice 9234292277 Receives reassigned benefits from 1 practitioner
Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1891898862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91567",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908091567",
            "telephone_number": "562-225-0178",
            "fax_number": "562-988-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "SUITE 260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-426-3319",
            "fax_number": "562-490-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG BEACH NEUROLOGICAL MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "LUBENS",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-426-3319",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "G32989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.