Active NPI
David W. Feazell, M.D.
- Pediatrics Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A115519
- Practice address
- 2825 Santa Monica Blvd
Ste. 104
Santa Monica, CA 90404-2429 - Phone
- (310) 829-9935
- Fax
- (310) 829-1077
- NPI assigned
- Jun 12, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A115519 | CA | Primary |
Addresses
Primary practice location
2825 Santa Monica Blvd
Ste. 104
Santa Monica, CA 90404-2429
Mailing address
2825 Santa Monica Blvd
Ste. 104
Santa Monica, CA 90404-2429
Phone (310) 829-9935
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992932388 | Medicaid | CA |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A115519 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Regents of the University of California | Current | Accepting new patients | |
| The Regents of the University of California | Current | Accepting new patients | |
| UC Regents | Pediatrics | Current | Accepting new patients |
| UCLA Medical Group | Pediatrics | Past | Accepting new patients |
| The Regents of the University of California | Past | Accepting new patients | |
| Providence Saint John'S Health Center | Past | Accepting new patients |
Locations
File 55737
Los Angeles, CA 90074
10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
File 2939
Los Angeles, CA 90074
Phone (310) 794-6596
2825 Santa Monica Blvd
Ste 104
Santa Monica, CA 90404
Phone (310) 289-9935
2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381
Interoperability endpoints
- dfeazell58684@direct.uclahealth.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1235107566
-
- Pediatrics Physician
- Los Angeles, CA
- NPI 1982667663
-
- Ambulatory Surgical Clinic/Center
- Valencia, CA
- NPI 1689200305
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1124026273
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1982849105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485129600000",
"number": "1992932388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 SANTA MONICA BLVD",
"address_2": "STE. 104",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042429",
"telephone_number": "310-829-9935",
"fax_number": "310-829-1077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 SANTA MONICA BLVD",
"address_2": "STE. 104",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042429",
"telephone_number": "310-829-9935",
"fax_number": "310-829-1077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEAZELL",
"first_name": "DAVID",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-12",
"last_updated": "2017-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A115519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992932388",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.