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MARIA GULTOM
NPI 1013391358
Internal Medicine - Cardiovascular Disease in Los Angeles, CA

Active since July 16, 2015PECOS Enrolled
100/100
CMS Quality Rating
100 UCLA MEDICAL PLZ STE 630, LOS ANGELES, CA 90024(310) 794-1276 Get Directions Write a Review

NPPES record last updated: July 7, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 7, 2020, Mar 17, 2018, Nov 14, 2017 (3 updates tracked since 2017).

About Maria Gultom NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIA GULTOM (NPI 1013391358) is an individual cardiovascular disease provider in Los Angeles, California, licensed in California (95002729) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1013391358
Entity TypeIndividualFemale
Primary Taxonomy207RC0000X
Provider Legal NameMARIA GULTOM
Location Address100 UCLA MEDICAL PLZ STE 630Los Angeles, CA 90024-6997
Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631 · (310) 267-9536
Phone(310) 794-1276
Sole ProprietorNo
Enumeration DateJuly 16, 2015
Last NPPES UpdateJuly 7, 20203 updates tracked since enumeration
NPPES CertifiedJuly 7, 2020
✔ NPI 1013391358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in CA · 95002729
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License 95002729 (CA)
100 UCLA MEDICAL PLZ STE 630, Los Angeles, CA 90024
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1757 Westwood Plz, Suite 7330FLos Angeles, CA 90095-8358 · Phone (310) 267-9536
Location 210833 Le Conte AveLos Angeles, CA 90095-3075 · Phone (310) 825-9820

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maria Gultom is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90024 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality95.72
Promoting Interoperability100
Improvement Activities40
Cost81.58

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAYA KING AGACNP-BC
Nurse Practitioner (Acute Care)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 825-9011
DR. MING-SING SI M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 825-9011
YAS SANAIHA
Thoracic Surgery (Cardiothoracic Vascular Surgery)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 206-8232
DR. BOBACK ZIAEIAN M.D.
Internal Medicine (Cardiovascular Disease)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 825-9011
NICHOLAS KEISUKE BROWNELL M.D.
Internal Medicine (Cardiovascular Disease)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 825-9011
NORMA TIEDGE MSN, AGACNP-BC
Nurse Practitioner (Gerontology)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 825-9011
JAMIL ANIS ABOULHOSN MD
Internal Medicine (Cardiovascular Disease)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 825-9011
STEFANIE BRENNAN NP
Nurse Practitioner (Adult Health)
100 UCLA MEDICAL PLZ STE 630
LOS ANGELES, CA 90024
Los Angeles County (310) 825-9011

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maria Gultom's NPI number?

The NPI number for Maria Gultom is 1013391358. It was assigned to this individual provider in the NPPES registry on July 16, 2015.

Where is Maria Gultom located?

Maria Gultom practices at 100 Ucla Medical Plz Ste 630, Los Angeles, CA 90024. The listed phone number is (310) 794-1276.

What is Maria Gultom's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Maria Gultom enrolled in Medicare?

Yes. Maria Gultom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maria Gultom was last updated on July 7, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.