NPIMap

Organization Active NPI

Cardiovascular Consultants Medical Group

  • Nuclear Cardiology Physician
  • Encino, CA
National Provider Identifier
1962108381
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Cardiology PhysicianTaxonomy code 207UN0901X
Legal business name
CARDIOVASCULAR CONSULTANTS MEDICAL GROUP
Practice address
16550 Ventura Blvd Ste 122
Encino, CA 91436-2004
Phone
(818) 782-5041
Fax
(818) 205-9091
NPI assigned
Feb 7, 2023
Last updated
Feb 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Kimberley A Litke
Title
Asst. Administrator
Phone
(818) 782-5041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207UN0901X Primary

Addresses

Primary practice location

16550 Ventura Blvd Ste 122
Encino, CA 91436-2004

Mailing address

16542 Ventura Blvd Ste 402
Encino, CA 91436-4562
Phone (818) 782-5041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000844 CA Part B Supplier - Clinic/Group Practice 5991786105 Receives reassigned benefits from 13 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Encino, CA; Los Angeles, CA; Mission Hills, CA; Valencia, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cardovascular Consultan3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14901 Rinaldi St
Ste 110
Mission Hills, CA 91345
Phone (818) 365-1339

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1962108381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16542 VENTURA BLVD STE 402",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364562",
            "telephone_number": "818-782-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16550 VENTURA BLVD STE 122",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362004",
            "telephone_number": "818-782-5041",
            "fax_number": "818-205-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CONSULTANTS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "LITKE",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASST. ADMINISTRATOR",
        "authorized_official_telephone_number": "818-782-5041"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.