Individual provider Active NPI

Thomas Oliver Kovacs, MD

  • Gastroenterology Physician
  • Los Angeles, CA
National Provider Identifier
1912926379
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G49595 Issued in CA
Practice address
200 Medical Plaza
#365,530,420,120
Los Angeles, CA 90095
Phone
(310) 825-1597
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G49595 CA Primary

Addresses

Primary practice location

200 Medical Plaza
#365,530,420,120
Los Angeles, CA 90095

Mailing address

5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 825-1597

Other identifiers 1

IdentifierTypeStateIssuer
00G495950MedicaidCA

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
I20100408000353 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 8022144526 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Jul 1, 2018 Accepting new patients
County of Los Angeles CurrentSince Jul 1, 2018 Accepting new patients

Locations

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

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

Organizations & group practices 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1912926379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-825-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "#365,530,420,120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-825-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACS",
        "first_name": "THOMAS",
        "middle_name": "OLIVER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G49595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G495950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.