Individual provider Active NPI

Tomas A Sevilla, M.D.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1922189125
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R207R00000X Issued in CA
Practice address
2813 N Broadway
Los Angeles, CA 90031-2611
Phone
(323) 342-9764
Fax
(323) 342-9656
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R207R00000X CA Primary

Addresses

Primary practice location

2813 N Broadway
Los Angeles, CA 90031-2611

Mailing address

PO Box 31340
Los Angeles, CA 90031-0340
Phone (323) 342-9764

Other names 1

  • Thomas A Sevilla Other name

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
I20040909001077 CA Practitioner - Internal Medicine 2961478995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2813 N Broadway
Los Angeles, CA 90031-2611
Phone (323) 342-9764

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R207R00000XCAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sevilla Medical Group Inc Internal Medicine CurrentSince Feb 1, 2010 Accepting new patients
Santa Teresita Medical Clinic Group Inc Specialist Past Accepting new patients

Locations

2913 N Broadway
Los Angeles, CA 90031

2813 N Broadway
Los Angeles, CA 90031
Phone (323) 342-9764

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1922189125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310340",
            "telephone_number": "323-342-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312611",
            "telephone_number": "323-342-9764",
            "fax_number": "323-342-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVILLA",
        "first_name": "TOMAS",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "R207R00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "SEVILLA",
            "middle_name": "A",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.