Active NPI
Ellis Norman Beesley Jr., M.D.
- Pediatric Adolescent Medicine Physician
- Los Angeles, CA
National Provider Identifier
1063470219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- A41548
- Practice address
- 1127 Wilshire Blvd
Suite 707
Los Angeles, CA 90017-3901 - Phone
- (213) 482-4830
- Fax
- (213) 482-0275
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | A41548 | CA | Primary |
Addresses
Primary practice location
1127 Wilshire Blvd
Suite 707
Los Angeles, CA 90017-3901
Mailing address
1127 Wilshire Blvd
Suite 707
Los Angeles, CA 90017-3901
Phone (213) 482-4830
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ellis.beesley.p1@direct.eisnerhealth.nextgenshare.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A41548 | CA | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1063470219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1127 WILSHIRE BLVD",
"address_2": "SUITE 707",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900173901",
"telephone_number": "213-482-4830",
"fax_number": "213-482-0275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 WILSHIRE BLVD",
"address_2": "SUITE 707",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900173901",
"telephone_number": "213-482-4830",
"fax_number": "213-482-0275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEESLEY",
"first_name": "ELLIS",
"middle_name": "NORMAN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "CA",
"license": "A41548",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ellis.beesley.p1@direct.eisnerhealth.nextgenshare.com",
"affiliation": "N",
"endpointDescription": "NextGenShare, Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1530 S Olive St",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900153023",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.