Raisa J Osipov, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A69109 Issued in CA

Practice address

5205 Melrose Ave
Los Angeles, CA 90038-3144

Phone

(310) 874-1807

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  Family Medicine

  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1902814973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29600 ISLAND VIEW DR",
            "address_2": "109",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902754650",
            "telephone_number": "310-541-8676",
            "fax_number": "310-541-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 MELROSE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383144",
            "telephone_number": "310-874-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSIPOV",
        "first_name": "RAISA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A69109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS ENROLLMENTID",
            "identifier": "120140809000112",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS PAC ID",
            "identifier": "539563835",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5665534",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Osias, MD
• Walter Alan Osias, M.D.
• Elicia Chizaram Osigwe
• Nwanneka Ikechukwu Osigwe
• Daria Osipchuk, MD
• Tira Oskoui
• Elizabeth Oslund, MD
• Kareem Osman
• Newal Osman, OTR
• Patricia Osman, MSW, CMSW

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.