Active NPI
Westcom Radiology Medical Group
- Diagnostic Radiology Physician
- Los Angeles, CA
National Provider Identifier
1912968231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- WESTCOM RADIOLOGY MEDICAL GROUP
- Practice address
- 6245 De Longpre Ave
Los Angeles, CA 90028-8253 - Phone
- (323) 462-2271
- NPI assigned
- Mar 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Martin A Schwartz, MD
- Title
- President
- Phone
- (323) 462-2271
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
6245 De Longpre Ave
Los Angeles, CA 90028-8253
Mailing address
PO Box 10076
Van Nuys, CA 91410-0076
Phone (805) 578-8300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ52740Z | Other | CA | BLUE SHIELD |
| GR0065300 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050513000786 | CA | Part B Supplier - Clinic/Group Practice | 4789625252 |
Receives reassigned benefits from 1 practitioner 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Los Angeles, CA; Paramount, CA |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Diagnostic Radiology Physician
- Los Angeles, CA
- NPI 1043271380
O20050513000786
-
- Diagnostic Radiology Physician
- Norwalk, CA
- NPI 1255392510
O20050513000786
-
- Diagnostic Radiology Physician
- Los Angeles, CA
- NPI 1326009655
O20050513000786
-
- Diagnostic Radiology Physician
- Los Angeles, CA
- NPI 1447491501
O20050513000786
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1258329600000",
"number": "1912968231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10076",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914100076",
"telephone_number": "805-578-8300",
"fax_number": "805-578-8950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6245 DE LONGPRE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900288253",
"telephone_number": "323-462-2271"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESTCOM RADIOLOGY MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-28",
"last_updated": "2009-11-16",
"status": "A",
"authorized_official_last_name": "SCHWARTZ",
"authorized_official_first_name": "MARTIN",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "323-462-2271",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ52740Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0065300",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.