Individual provider Active NPI

David W. Feazell, M.D.

  • Pediatrics Physician
  • Santa Monica, CA
National Provider Identifier
1992932388
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A115519 Issued in CA
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

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1992932388MedicaidCA

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
I20120801000247 CA Practitioner - Pediatric Medicine 3971769258 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A115519CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Jun 1, 2012 Accepting new patients
The Regents of the University of California CurrentSince Jun 1, 2012 Accepting new patients
UC Regents Pediatrics CurrentSince Oct 22, 2012 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.