OLIVIA TAEKO ISHIBASHI (MD, MPH) – Family Medicine Physician, NPI 1033670138
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
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Provider Addresses for OLIVIA TAEKO ISHIBASHI (MD, MPH)
1920, Colorado Avenue, Santa Monica, Los Angeles County, California, 90404, United States
SANTA MONICA, CA 904043414
Phone: (310) 319-4711
Type: Mailing
5767 W CENTURY BLVD STE 400
LOS ANGELES, CA 900455631
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-05-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220516002496 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 118 | 76 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 74 | 65 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 24 | 24 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 19 | 18 | $0 |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | 17 | 17 | $0 |
Insurance plans in this area (ZIP 90404)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CA | |
| Family Practice, Addiction Medicine | CA | |
| Family Practice | CA | |
| Family Practice, Sports Medicine | CA | |
| Family Practice, Sports Medicine | CA | |
| - | CA | |
| Family Practice | CA | |
| Internal Medicine | CA | |
| Family Practice | CA | |
| - | CA |
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