Active NPI
Ronald Leonard Polito, M.D.
- Internal Medicine Physician
- La Canada, CA
National Provider Identifier
1992053441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- AFE22005
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140407001290 | CA | Order and Referring Only - Internal Medicine | 3779715735 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AFE22005 | CA | MD | Internal Medicine Physician |
| 22005 | CA | MD | Physical 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.