Individual provider Active NPI

Michael Lawrence Sporty, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1922269950
Registry record updated Apr 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
1200 N State St RM 1011
Los Angeles, CA 90033-1029
Phone
(323) 226-6667
NPI assigned
Jun 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0 CA Primary

Addresses

Primary practice location

1200 N State St RM 1011
Los Angeles, CA 90033-1029

Mailing address

1200 N State St RM 1011
Los Angeles, CA 90033-1029
Phone (323) 226-6667

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
I20120418000431 CA Practitioner - Emergency Medicine 3072774025 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111836CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Intercommunity Emergency Medical Group Emergency Medicine CurrentSince Jul 2, 2012 Accepting new patients
Los Angeles County, University of Southern California Hospital Past Accepting new patients
Usc Care Medical Group, Inc Past Accepting new patients
Emergency Medicine Specialists of Orange County Emergency Medicine Past Accepting new patients

Locations

11500 Brookshire Ave
Downey, CA 90241
Phone (562) 904-5000

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270944000000",
    "number": "1922269950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST RM 1011",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST RM 1011",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORTY",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2010-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.