Individual provider Active NPI

Mark Robert Hanudel, MD

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1891956710
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
110834 Issued in CA
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-3075
Phone
(310) 206-6987
NPI assigned
Jun 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 110834 CA
Pediatrics Physician 208000000X 110834 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-3075

Mailing address

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

Other practice location 1

14445 Olive View Drive
Sylmar, CA 91342
Phone (818) 364-3233

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
I20140718001581 CA Practitioner - Pediatric Medicine 2466678909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Harvard Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UC RegentsGroup PAC ID 4587568829, 97 clinicians

Practice addresses (Care Compare)

10630 Santa Monica Blvd
Los Angeles, CA 90025-4837
Phone (310) 954-2700

10833 Le Conte Ave
Los Angeles, CA 90095-3075

10833 Leconte Ave
Los Angeles, CA 90095-3075
Phone (310) 825-9124

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 825-8021

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
82.13
Promoting interoperability
100
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110834CAMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Pediatrics CurrentSince Jul 1, 2014 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Medical Group Pediatrics Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

10833 Le Conte Ave
Los Angeles, CA 90095
Phone (310) 301-8932

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

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

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Interoperability endpoints

  • Direct secure messaging: mhanudel811649@direct.memorialcare.org
  • Direct secure messaging: mhanudel38259@direct.uclahealth.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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1891956710",
    "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": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-206-6987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14445 Olive View Drive",
            "address_purpose": "LOCATION",
            "city": "Sylmar",
            "state": "CA",
            "postal_code": "91342",
            "country_code": "US",
            "telephone_number": "818-364-3233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANUDEL",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CA",
            "license": "110834",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "110834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.