Timothy Wayne Casarez, MD
Individual provider Active NPI Pediatric Cardiology Physician · Encino, CA
NPI 1992782148 · NPPES record last updated Nov 30, 2011
Key facts
- NPI
- 1992782148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Cardiology Physician 2080P0202X
- License
- A73301 (CA)
- Practice address
- 5400 Balboa Blvd
Suite 202 Pediatric Cardiology Med Assoc of So Cal
Encino, CA 91316-1502 - Phone
- (818) 784-6269
- Fax
- (818) 784-1531
- NPI assigned
- Dec 29, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060209000689 | CA | Practitioner - Pediatric Medicine | 7214942374 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (14 of 15)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Ventura | Current |
Accepting new patients | |
| Providence Health System - Southern California | Past | Accepting new patients | |
| Simi Valley Hospital and Health Care Services | Past | Accepting new patients | |
| Antelope Valley Health Care District | Past | Accepting new patients | |
| Community Memorial Health System | Past | Accepting new patients | |
| Dignity Community Care | Past | Accepting new patients | |
| Valley Presbyterian Hospital | Past | Accepting new patients | |
| Los Robles Regional Medical Center | Past | Accepting new patients | |
| Childrens Hospital of Los Angeles | Past | Accepting new patients | |
| Henry Mayo Newhall Memorial Hospital | Past | Accepting new patients | |
| Tarzana Medical Center LLC | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Cedars-Sinai Medical Center | Past | Accepting new patients | |
| Providence Health System - Southern California | Past | Accepting new patients |
Locations
300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100
300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | A73301 | CA | Yes |
Addresses
Primary practice location
5400 Balboa Blvd
Suite 202 Pediatric Cardiology Med Assoc of So Cal
Encino, CA 91316-1502
Mailing address
5400 Balboa Blvd
Suite 202 Pediatric Cardiology Med Assoc of So Cal
Encino, CA 91316-1502
Phone (818) 784-6269
Other providers in Encino, CA
- Jaycie Carter
- Michael Joseph Carter
- Tikoa Minyonne Carter
- Robyn Caruso
- Danielle Casale
- Andrea Casas
- Alexandria Nicole Casey
- Kathleen Cashman
- Desoree Joana Cashuex
- Christina Lynn Cassel
All providers in Encino, CA · Pediatric Cardiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.