In-Line Medical, Inc., a Professional Medical Corporation

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

75506 Issued in CA

Legal business name

IN-LINE MEDICAL, INC., A PROFESSIONAL MEDICAL CORPORATION

Practice address

16311 Ventura Blvd Ste 1065-B
Encino, CA 91436-2124

Phone

(310) 278-7000

NPI assigned

Sep 18, 2017

Organization subpart

No

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

Authorized official

Name

Tooraj Gravori, MD

Title

President

Phone

(310) 278-7000

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• In-Line Medical, Inc., a Professional Medical Corporation

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Los Angeles, CA
  • NPI 1285274035

  5193060440

  Same PAC ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peyman Gravori

  • Interventional Pain Medicine Physician
  • Encino, CA
  • NPI 1841615762

  Single Specialty

  Medicare reassignment NPD
• Murisiku Raifu, M.D.

  • Neurological Surgery Physician
  • Flushing, NY
  • NPI 1467616003

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1982123329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16350 VENTURA BLVD # D569",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365300",
            "telephone_number": "310-278-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 1065-B",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "310-278-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN-LINE MEDICAL, INC., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "GRAVORI",
        "authorized_official_first_name": "TOORAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-278-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "75506",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "14719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Encino, CA
• Providers in Encino, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.