NPIMap

Organization Active NPI

Maloney-Shamie Vision Institute

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1922501154
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MALONEY-SHAMIE VISION INSTITUTE
Practice address
10921 Wilshire Blvd Ste 900
Los Angeles, CA 90024-4003
Phone
(310) 415-6627
Fax
(310) 208-0169
NPI assigned
Mar 14, 2018
Last updated
Apr 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Authorized official

Name
Pamela D Sullivan
Title
Practice Administrator
Phone
(310) 208-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

10921 Wilshire Blvd Ste 900
Los Angeles, CA 90024-4003

Mailing address

10921 Wilshire Blvd Ste 900
Los Angeles, CA 90024-4003
Phone (310) 415-6627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430002047 CA Part B Supplier - Clinic/Group Practice 7012271992 Receives reassigned benefits from 8 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

10921 Wilshire Blvd
Ste 900
Los Angeles, CA 90024
Phone (310) 208-3937

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554163200000",
    "number": "1922501154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 900",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244003",
            "telephone_number": "310-415-6627",
            "fax_number": "310-208-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 900",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244003",
            "telephone_number": "310-415-6627",
            "fax_number": "310-208-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALONEY-SHAMIE VISION INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-14",
        "last_updated": "2019-04-02",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "310-208-3937"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 2, 2019; 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.

Verify at the official NPI Registry.