Jessica Erin Channick

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

A166654 Issued in CA

Practice address

200 UCLA Medical PLZ Ste 365B
Los Angeles, CA 90095-7419

Phone

(310) 825-7921

NPI assigned

Mar 26, 2018

Last updated

Jun 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pulmonary DiseaseAlso: Internal Medicine

Education

Tufts University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
• Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score

87.51 of 100Reported as group

Quality

79.37

Promoting interoperability

100

Improvement activities

40

Cost

73.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Regents of the University of California

  dba UCLA Dept of Medicine

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566

  Pulmonary Disease

  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• The Regents of the University of California

  dba UCLA Dept of Medicine

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the Univ of California

  dba Santa MonicaUCLAMC and Orthopedic Hospital

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1427055839
  Care Compare affiliation
• Regents Univ of Calif Los Angeles

  dba Ronald Reagan UCLA Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1902803315
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1053816892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 365B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957419",
            "telephone_number": "310-825-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANNICK",
        "first_name": "JESSICA",
        "middle_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A166654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blanca C Chaniago, LMFT
• Craig Michael Chanin, M.D.
• Niramol Chankitwanit, R.D.
• Samuel Tumson Chanmany
• Channel Hospice
• Stephanie Channual
• Lidia Chanon
• Christine Keshia Chansamone, DPT
• Chantel Cortinovis, Psy.D., a Professional Psychology Corporation
• Chantiste Beal DDS Inc (Chantiste Beal)

• Pulmonary Disease Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.