Individual provider Active NPI

Bibiana Jin-Wan Reiser, M.D.

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1912071663
Registry record updated Oct 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A81507 Issued in CA
Practice address
1450 San Pablo St
Suite 4000
Los Angeles, CA 90033-4668
Phone
(323) 442-6335
Fax
(323) 442-7166
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A81507 CA Primary

Addresses

Primary practice location

1450 San Pablo St
Suite 4000
Los Angeles, CA 90033-4668

Mailing address

1450 San Pablo St
Suite 3700
Los Angeles, CA 90033-4668
Phone (323) 442-7152

Other identifiers 1

IdentifierTypeStateIssuer
A81507OtherCAMEDICAL LICENSE

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
I20070131000675 CA Practitioner - OphthalmologyPractitioner - Pediatric Medicine 7113929324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Pediatric Medicine
Education
University of Southern California Keck School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-8408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81507CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Oct 26, 2009 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

3250 Wilshire Blvd
Ste 1101
Los Angeles, CA 90010

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414195200000",
    "number": "1912071663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST",
            "address_2": "SUITE 3700",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334668",
            "telephone_number": "323-442-7152",
            "fax_number": "323-442-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST",
            "address_2": "SUITE 4000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334668",
            "telephone_number": "323-442-6335",
            "fax_number": "323-442-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISER",
        "first_name": "BIBIANA",
        "middle_name": "JIN-WAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2014-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A81507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A81507",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.