Individual provider Active NPI

Jude T Gineta, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1093401457
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024592 Issued in CA
Practice address
4742 Eagle Rock Blvd
Los Angeles, CA 90041-2736
Phone
(323) 474-6016
Fax
(323) 471-1761
NPI assigned
Apr 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95024592 CA Primary

Addresses

Primary practice location

4742 Eagle Rock Blvd
Los Angeles, CA 90041-2736

Mailing address

4742 Eagle Rock Blvd
Los Angeles, CA 90041-2736
Phone (323) 474-6016

Other practice location 1

4867 Eagle Rock Blvd
Los Angeles, CA 90041-2657
Phone (323) 254-6754

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022001018 CA Practitioner - Nurse Practitioner 5092253880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Rock Medical CenterGroup PAC ID 7810350410, 3 clinicians

Practice addresses (Care Compare)

4742 Eagle Rock Blvd
Los Angeles, CA 90041-2736
Phone (323) 474-6016

4867 Eagle Rock Blvd
Suite 1
Los Angeles, CA 90041-2649
Phone (323) 254-6754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95024592CAMDRegistered Nurse
751292CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Rock Medical Center CurrentSince Jul 6, 2025 Accepting new patients
Oui We Care Medical Corporation CurrentSince Nov 13, 2025 Accepting new patients
All Health Medical Group, Inc Past Accepting new patients

Locations

4742 Eagle Rock Blvd
Los Angeles, CA 90041
Phone (323) 474-6016

4867 Eagle Rock Blvd
Los Angeles, CA 90041
Phone (323) 254-6754

4867 Eagle Rock Blvd
Ste 1
Los Angeles, CA 90041
Phone (323) 254-6754

11048 Washington Blvd
Whittier, CA 90606
Phone (562) 692-5998

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1093401457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4742 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412736",
            "telephone_number": "323-474-6016",
            "fax_number": "323-471-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4742 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412736",
            "telephone_number": "323-474-6016",
            "fax_number": "323-471-1761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4867 Eagle Rock Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900412657",
            "country_code": "US",
            "telephone_number": "323-254-6754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GINETA",
        "first_name": "JUDE",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.