Individual provider Active NPI

Barry B Ceverha, M.D.

  • Neurological Surgery Physician
  • Long Beach, CA
National Provider Identifier
1972576486
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
G29654 Issued in CA
Practice address
3828 Schaufele Ave
Suite 340
Long Beach, CA 90808-1791
Phone
(562) 427-5388
Fax
(562) 427-6467
NPI assigned
Feb 7, 2006
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G29654 CA
Neurological Surgery Physician 207T00000X G29654 CA Primary

Addresses

Primary practice location

3828 Schaufele Ave
Suite 340
Long Beach, CA 90808-1791

Mailing address

17360 Brookhurst St
Attn: MCMF- Credentialing Department
Fountain Valley, CA 92708-3720

Other identifiers 1

IdentifierTypeStateIssuer
00G29654MedicaidCA

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
I20110628000258 CA Practitioner - Neurosurgery 6305024050 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Neurological Surgery CurrentSince Nov 15, 2013 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Barry B. Ceverha, M.D., Inc. Specialist PastSince Mar 29, 2011 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

2865 Atlantic Ave
Ste 202
Long Beach, CA 90806
Phone (562) 427-5388

3828 Schaufele Ave
Ste 340
Long Beach, CA 90808
Phone (562) 427-5388

Organizations & group practices 3

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1972576486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "address_2": "ATTN: MCMF- CREDENTIALING DEPARTMENT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 SCHAUFELE AVE",
            "address_2": "SUITE 340",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081791",
            "telephone_number": "562-427-5388",
            "fax_number": "562-427-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEVERHA",
        "first_name": "BARRY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G29654",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G29654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G29654",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.