BRENTWOOD ORTHOPEDIC AND SPINE SURGERY LLC
NPI 1821498635
Clinic/Center - Ambulatory Surgical in Los Angeles, CA

Q: What is Brentwood Orthopedic And Spine Surgery LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since August 28, 2014CLIA 05D2324007 · Waiver

11980 SAN VICENTE BLVD, SUITE 110, LOS ANGELES, CA 90049(310) 337-7463(310) 442-8336 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 11, 2024, Mar 10, 2022, Mar 3, 2022 (3 updates tracked since 2022).

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About Brentwood Orthopedic And Spine Surgery Llc NPPES

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

BRENTWOOD ORTHOPEDIC AND SPINE SURGERY LLC (NPI 1821498635) is a healthcare organization registered as an ambulatory surgical in Los Angeles, California and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through May 15, 2027 and lists Moshe H. Wilker, President, as its authorized official.

NPPES Registry Identity

NPI1821498635

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameBRENTWOOD ORTHOPEDIC AND SPINE SURGERY LLC

Location Address11980 SAN VICENTE BLVD, SUITE 110Los Angeles, CA 90049-5012

Mailing Address11980 San Vicente Blvd, Suite 110Los Angeles, CA 90049-5012 · (310) 337-7463 · Fax (310) 442-8336

Phone(310) 337-7463

Fax(310) 442-8336

Organization SubpartNo

Authorized OfficialMoshe H. WilkerPresident · (310) 337-7463

Enumeration DateAugust 28, 2014

Last NPPES UpdateNovember 11, 20243 updates tracked since enumeration

NPPES CertifiedNovember 11, 2024

✔ NPI 1821498635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

License✔ Licensed in CA · A100370

11980 SAN VICENTE BLVD, Los Angeles, CA 90049

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2324007

Brentwood Orthopedic And Spone Surgery, LLC · Los Angeles, CA

Active · expires May 15, 2027

CLIA Number05D2324007

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateMay 16, 2025

Certificate Expiration DateMay 15, 2027

Laboratory DirectorMoshe H. Wilker

Laboratory Phone(310) 207-2677

Laboratory LocationBrentwood Orthopedic And Spone Surgery, LLC11980 San Vicente Blvd Suite 110, Los Angeles, CA 90049

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 9

Medicare supplier enrollment and the product categories Brentwood Plaza Pharmacy carries, from the Medicare DMEPOS supplier directory.

Brentwood Plaza Pharmacy

DMEPOS supplier · Los Angeles, CAOperated by Colfax Pharmaceutical Inc

✔

Accepts Medicare assignment

Brentwood Plaza Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20478803

Medicare Participant SinceMarch 3, 2016

Supplier Location11980 San Vicente Blvd Ste 104Los Angeles, CA 90049

Phone(310) 820-1496

Supplier Specialties

Pharmacy

Medicare Product Categories

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Heat & Cold Applications

Heat therapy, Cold therapy, Heating pads

Canes and/or Crutches

Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches

Walkers

Standard Walkers, Wheeled Walkers, Folding Walker

Orthoses: Off-The-Shelf

Met pads, Heel pads, Heel spur pads

Urological Supplies

Catheters, Urinary collection devices

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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.

DR. DIANA MARCELA MEDINA DDS

Dentist (Oral and Maxillofacial Surgery)

11980 SAN VICENTE BLVD, SUITE 505
LOS ANGELES, CA 90049

Los Angeles County (310) 820-6691

JESSICA SANCHEZ MFT

Marriage & Family Therapist

11980 SAN VICENTE BLVD, SUITE 909
LOS ANGELES, CA 90049

Los Angeles County (424) 293-6679

DR. HOPE W LEVIN MD

Psychiatry & Neurology (Child & Adolescent Psychiatry)

11980 SAN VICENTE BLVD, SUITE 809
LOS ANGELES, CA 90049

Los Angeles County (310) 494-0108

DR. CAROL ANN MAYHEW PH.D.

Psychologist (Clinical)

11980 SAN VICENTE BLVD, SUITE 709
LOS ANGELES, CA 90049

Los Angeles County (310) 207-9902

DR. ANURADHA GOMATHY SESHADRI M.D.

Internal Medicine

11980 SAN VICENTE BLVD, STE 102
LOS ANGELES, CA 90049

Los Angeles County (310) 208-7777

REGINA PALLY M.D.

Psychologist (Prescribing (Medical))

11980 SAN VICENTE BLVD, SUITE 810
LOS ANGELES, CA 90049

Los Angeles County (310) 820-2700

ARCHANA M REDDY MD

Family Medicine

11980 SAN VICENTE BLVD, SUITE 102
LOS ANGELES, CA 90049

Los Angeles County (310) 208-7777

ALAN SPIVAK

Psychologist (Clinical)

11980 SAN VICENTE BLVD, STE 712
LOS ANGELES, CA 90049

Los Angeles County (310) 826-1494

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 Brentwood Orthopedic And Spine Surgery LLC's NPI number?

The NPI number for Brentwood Orthopedic And Spine Surgery LLC is 1821498635. It was assigned to this organization in the NPPES registry on August 28, 2014.

Where is Brentwood Orthopedic And Spine Surgery LLC located?

Brentwood Orthopedic And Spine Surgery LLC is located at 11980 San Vicente Blvd Suite 110, Los Angeles, CA 90049. The listed phone number is (310) 337-7463.

What is Brentwood Orthopedic And Spine Surgery LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Brentwood Orthopedic And Spine Surgery LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Brentwood Plaza Pharmacy accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Brentwood Orthopedic And Spine Surgery LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2324007) is associated with this NPI, valid through May 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Brentwood Orthopedic And Spine Surgery LLC was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.