NPIMap

Individual provider Active NPI

Timur R Pogodin, M.D

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1972994853
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A133706 Issued in CA
Practice address
10228 Tabor St
Apt 8
Los Angeles, CA 90034-4836
Phone
(626) 316-2275
NPI assigned
Feb 12, 2015
Last updated
Feb 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A133706 CA Primary

Addresses

Primary practice location

10228 Tabor St
Apt 8
Los Angeles, CA 90034-4836

Mailing address

10228 Tabor St
Apt 8
Los Angeles, CA 90034-4836
Phone (626) 316-2275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229002613 CA Practitioner - General PracticePractitioner - Family Practice 1951618958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Av Pediatrics Medical Associates. Inc.Group PAC ID 8628052404, 5 clinicians

Practice addresses (Care Compare)

1523 W Ave J
Suite 7
Lancaster, CA 93534-2819
Phone (661) 945-2221

27141 Hidaway Ave
Suite 204
Santa Clarita, CA 91351-4147
Phone (818) 507-8181

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133706CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Public Health Current Accepting new patients
P.C. Medical Clinic Current Accepting new patients
Porter Ranch Medical Center PastSince Sep 2, 2016 Accepting new patients
Tahseen Shareef MD, Inc Past Accepting new patients
Kirit Shah, M.D. Inc. Past Accepting new patients

Locations

631 E Colorado St
Ste C
Glendale, CA 91205
Phone (818) 507-1881

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: timurpogodin-ncaddsgv@lacsapc.netsmartdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1972994853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10228 TABOR ST",
            "address_2": "APT 8",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344836",
            "telephone_number": "626-316-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10228 TABOR ST",
            "address_2": "APT 8",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344836",
            "telephone_number": "626-316-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGODIN",
        "first_name": "TIMUR",
        "middle_name": "R",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A133706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.