Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

OLIVIA TAEKO ISHIBASHI MD, MPH
NPI 1033670138
Family Medicine in Santa Monica, CA

Q: What is Olivia Ishibashi's NPI number?

The NPI number for Olivia Ishibashi is 1033670138. It was assigned to this individual provider in the NPPES registry on March 29, 2019.

Q: What is Olivia Ishibashi's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Olivia Ishibashi was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 29, 2019PECOS Enrolled

1920 COLORADO AVE, SANTA MONICA, CA 90404(310) 319-4700(310) 453-5106 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 9, 2025, Jul 14, 2022, Jul 4, 2022 (3 updates tracked since 2022).

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About Olivia Taeko Ishibashi Md, Mph NPPES

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

OLIVIA TAEKO ISHIBASHI MD, MPH (NPI 1033670138) is an individual family medicine provider in Santa Monica, California, licensed in California (A178419) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Van Nuys, and is a graduate of University Of California, Geffen School Of Medicine (2019).

NPPES Registry Identity

NPI1033670138

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameOLIVIA TAEKO ISHIBASHICredential: MD, MPH

Location Address1920 COLORADO AVESanta Monica, CA 90404-3414

Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631

Phone(310) 319-4700

Fax(310) 453-5106

Sole ProprietorNo

Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 2019

Enumeration DateMarch 29, 2019

Last NPPES UpdateOctober 20, 20263 updates tracked since enumeration

NPPES CertifiedOctober 20, 2026

✔ NPI 1033670138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · A178419

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedFamily Medicine · Adolescent MedicineTaxonomy 207QA0000X · License A178419 (CA)

Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X · License A178419 (CA)

1920 COLORADO AVE, Santa Monica, CA 90404

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Secondary Practice Location 1

Location 17515 Van Nuys BlvdVan Nuys, CA 91405-1949 · Phone (818) 627-3000 · Fax (818) 947-4027

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Olivia Taeko Ishibashi Md, Mph is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638581044

PECOS Enrollment IDI20220516002496

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.

Medicare Billing Reassignments

Medicare enrollment records show Olivia Ishibashi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Uc Regents

Same address

Family Medicine

1920 COLORADO AVE
Santa Monica, CA 90404

Reassigned Medicare billing, California enrollment
49 clinicians in this Medicare group

NPI 1275591802 (310) 319-4700

County Of Los Angeles

0.8 mi

Public Health, State or Local

2509 PICO BLVD
Santa Monica, CA 90405

Reassigned Medicare billing, California enrollment
1,939 clinicians in this Medicare group

NPI 1235323080 (310) 998-3203

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

150 services79 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

82 services69 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

29 services29 patients

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes G0446

This is a yearly, personal consultation focused on behaviors affecting heart health. It lasts 15 minutes and may cover topics like diet, exercise, and stress management. It's about learning healthy habits to protect your heart.

25 services25 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

22 services22 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

17 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90404 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MERON ABREHAM MD

Family Medicine