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MR. JOHN LOUIS VICELJA D.D.S.
NPI 1083875694
Dentist - General Practice in Redondo Beach, CA

Active since June 17, 2008Opted out of Medicare · through Jun 17, 2027
1711 VIA EL PRADO, 303, REDONDO BEACH, CA 90277(310) 792-4833(310) 792-4837 Get Directions Write a Review

NPPES record last updated: June 17, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. John Louis Vicelja D.d.s. NPPES

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

MR. JOHN LOUIS VICELJA D.D.S. (NPI 1083875694) is an individual general practice provider in Redondo Beach, California, licensed in California (33396) and active in the NPI registry since June 2008. He has opted out of Medicare through June 17, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1083875694
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameMR. JOHN LOUIS VICELJACredential: D.D.S.
Location Address1711 VIA EL PRADO, 303Redondo Beach, CA 90277-5714
Mailing Address1711 Via El Prado, 303Redondo Beach, CA 90277-5714 · (310) 792-4833 · Fax (310) 792-4837
Phone(310) 792-4833
Fax(310) 792-4837
Sole ProprietorYes
Enumeration DateJune 17, 2008
✔ NPI 1083875694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 33396
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1711 VIA EL PRADO, Redondo Beach, CA 90277
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. John Louis Vicelja D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 17, 2015 through June 17, 2027.

Opt-Out Effective DateJune 17, 2015
Opt-Out In Effect ThroughJune 17, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90277 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
$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.

Other Providers at the Same Location NPPES 11

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

SABRINA RENEE BESSON M.A. CCC-SLP
Speech-Language Pathologist
1711 VIA EL PRADO, SUITE 301
REDONDO BEACH, CA 90277
Los Angeles County (310) 683-8805
LELAND G WHITSON MD INC
Preferred Provider Organization
1711 VIA EL PRADO, SUITE 201
REDONDO BEACH, CA 90277
Los Angeles County (310) 698-5252
GREGORY SHVARTSMAN DDS DENTAL CORPORATION
Dentist (General Practice)
1711 VIA EL PRADO, STE 400B
REDONDO BEACH, CA 90277
Los Angeles County (310) 792-8610
GEORGE E ALEXANDER M.D.
Internal Medicine
1711 VIA EL PRADO, 202
REDONDO BEACH, CA 90277
Los Angeles County (310) 316-1764
DR. ROBERT A BARMORE D.D.S.
Dentist (General Practice)
1711 VIA EL PRADO, SUITE 400
REDONDO BEACH, CA 90277
Los Angeles County (310) 540-5444
DR. GREGORY IGOR SHVARTSMAN D.D.S.
Dentist (General Practice)
1711 VIA EL PRADO, STE 400B
REDONDO BEACH, CA 90277
Los Angeles County (310) 792-8610
GEORGE ERIC ALEXANDER A MEDICAL CORPORATION
Internal Medicine
1711 VIA EL PRADO, SUITE 202
REDONDO BEACH, CA 90277
Los Angeles County (310) 316-1764
DR. KARL ROBERT BINGEMANN D.D.S.
Dentist (General Practice)
1711 VIA EL PRADO, SUITE 400B
REDONDO BEACH, CA 90277
Los Angeles County (310) 792-8610

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 John Vicelja's NPI number?

The NPI number for John Vicelja is 1083875694. It was assigned to this individual provider in the NPPES registry on June 17, 2008.

Where is John Vicelja located?

John Vicelja practices at 1711 Via El Prado 303, Redondo Beach, CA 90277. The listed phone number is (310) 792-4833.

What is John Vicelja's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is John Vicelja enrolled in Medicare?

No. John Vicelja has opted out of Medicare through June 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for John Vicelja was last updated on June 17, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.