Individual provider Active NPI

Larry Jack Baraff, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1083630883
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
C35538 Issued in CA
Practice address
757 Westwood PLZ
RM 14-19
Los Angeles, CA 90095-3075
Phone
(310) 825-2111
Fax
(310) 794-0599
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C35538 CA
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X C35538 CA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X C35538 CA Primary

Addresses

Primary practice location

757 Westwood PLZ
RM 14-19
Los Angeles, CA 90095-3075

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
00C355380MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C35538CAMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Medical Group Emergency Medicine PastSince Dec 16, 2020 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1083630883",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "address_2": "RM 14-19",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-2111",
            "fax_number": "310-794-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAFF",
        "first_name": "LARRY",
        "middle_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C35538",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "C35538",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "C35538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C355380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "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 Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.