Individual provider Active NPI

Ronald Leonard Polito, M.D.

  • Internal Medicine Physician
  • La Canada, CA
National Provider Identifier
1992053441
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
AFE22005 Issued in CA
Practice address
4381 Shepherds Lane
La Canada, CA 91011
Phone
(818) 421-4446
Fax
(818) 790-0118
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AFE22005 CA Primary
Cardiovascular Disease Physician 207RC0000X AFE22005 CA

Addresses

Primary practice location

4381 Shepherds Lane
La Canada, CA 91011

Mailing address

PO Box 1598
La Canada, CA 91012
Phone (818) 421-4446

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
I20140407001290 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3779715735

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AFE22005CAMDInternal Medicine Physician
22005CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1992053441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1598",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "91012",
            "telephone_number": "818-421-4446",
            "fax_number": "818-790-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 SHEPHERDS LANE",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "91011",
            "telephone_number": "818-421-4446",
            "fax_number": "818-790-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "RONALD",
        "middle_name": "LEONARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "AFE22005",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "AFE22005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada, CA

Sources for this page

Verify at the official NPI Registry.