Active NPI
Alexander Seliverstov, M.D.
- Anesthesiology Physician
- Northridge, CA
National Provider Identifier
1962477034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A76611
- Practice address
- 18300 Roscoe Blvd
Northridge, CA 91325-4105 - Phone
- (818) 885-5375
- Fax
- (818) 715-1722
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A76611 | CA | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | A76611 | CA |
Addresses
Primary practice location
18300 Roscoe Blvd
Northridge, CA 91325-4105
Mailing address
PO Box 7001
Tarzana, CA 91357-7001
Phone (818) 888-7815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76611 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1962477034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7001",
"city": "TARZANA",
"state": "CA",
"postal_code": "913577001",
"telephone_number": "818-888-7815",
"fax_number": "818-715-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 ROSCOE BLVD",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913254105",
"telephone_number": "818-885-5375",
"fax_number": "818-715-1722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELIVERSTOV",
"first_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-21",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A76611",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "CA",
"license": "A76611",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.