Organization Active NPI

UC Regents

Doing business as UCLA Dept of Pediatric Grp Practice

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1982667663
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UC REGENTS
Doing business as
UCLA Dept of Pediatric Grp Practice
Practice address
200 UCLA Medical Plaza
Suite 265
Los Angeles, CA 90095-8344
Phone
(310) 825-0867
Fax
(310) 206-5146
NPI assigned
Apr 11, 2006
Last updated
Nov 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Authorized official

Name
Sherin Devaskar, M.D.NPI 1710907639
Title
Interim Executive Chair
Phone
(370) 825-5095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary
Neonatal-Perinatal Medicine Physician 2080N0001X NU
Developmental - Behavioral Pediatrics Physician 2080P0006X NU
Pediatric Allergy/Immunology Physician 2080P0201X NU
Pediatric Cardiology Physician 2080P0202X NU
Pediatric Critical Care Medicine Physician 2080P0203X NU
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X NU
Pediatric Endocrinology Physician 2080P0205X NU
Pediatric Gastroenterology Physician 2080P0206X NU
Pediatric Hematology & Oncology Physician 2080P0207X NU
Pediatric Infectious Diseases Physician 2080P0208X NU
Pediatric Nephrology Physician 2080P0210X NU
Pediatric Pulmonology Physician 2080P0214X NU
Pediatric Rheumatology Physician 2080P0216X NU
Pediatric Sports Medicine Physician 2080S0010X NU

Addresses

Primary practice location

200 UCLA Medical Plaza
Suite 265
Los Angeles, CA 90095-8344

Mailing address

10833 Le Conte Ave
32-263 CHS
Los Angeles, CA 90095-3075
Phone (310) 206-3952

Other names 1

  • UCLA Dept of Pediatric Grp Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119001005 CA Part B Supplier - Clinic/Group Practice 4587568829 Receives reassigned benefits from 319 practitioners
Practice locations: Rolling Hills Estates, CA; San Luis Obispo, CA; Santa Monica, CA; Simi Valley, CA; Thousand Oaks, CA; Torrance, CA; West Hills, CA; West Hollywood, CA…

National Provider Directory

National Provider Directory

Locations

26585 Agoura Rd
Ste 360
Calabasas, CA 91302
Phone (310) 825-2631

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

10833 Le Conte Ave
#32263
Los Angeles, CA 90095
Phone (310) 206-3952

10833 Le Conte Ave
#A2410
Los Angeles, CA 90095
Phone (310) 206-4616

10833 Le Conte Ave
Ste 12311
Los Angeles, CA 90095
Phone (310) 825-9124

10833 Leconte Ave 12494 Mdcc
Los Angeles, CA 90095
Phone (310) 825-9124

200 Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-6581

200 Medical Plz
Ste 330
Los Angeles, CA 90095
Phone (310) 267-7669

2501 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 546-8702

800 Fairmount Ave
Ste 415
Pasadena, CA 91105
Phone (626) 449-8440

892 Aerovista Pl
Ste 210
San Luis Obispo, CA 93401
Phone (805) 549-8023

1260 15th St
Ste 1002
Santa Monica, CA 90404
Phone (424) 259-8570

1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570

Practitioners & affiliated clinicians

Practitioners 381

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 381

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1982667663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "32-263 CHS",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-206-3952",
            "fax_number": "310-206-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLAZA",
            "address_2": "SUITE 265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-825-0867",
            "fax_number": "310-206-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC REGENTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "DEVASKAR",
        "authorized_official_first_name": "SHERIN",
        "authorized_official_title_or_position": "INTERIM EXECUTIVE CHAIR",
        "authorized_official_telephone_number": "370-825-5095",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCLA Dept of Pediatric Grp Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.