Individual provider Active NPI

Jason Stoddard, D.C.

  • Chiropractor
  • Long Beach, CA
National Provider Identifier
1104219690
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33217 Issued in CA
Practice address
1777 N Bellflower Blvd
Suite 107
Long Beach, CA 90815-4013
Phone
(562) 280-3770
NPI assigned
Mar 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33217 CA Primary

Addresses

Primary practice location

1777 N Bellflower Blvd
Suite 107
Long Beach, CA 90815-4013

Mailing address

1777 N Bellflower Blvd
Suite 107
Long Beach, CA 90815-4013
Phone (562) 280-3770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180323001066 CA Practitioner - Chiropractic 1254693666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Rehab and Wellness Center IncGroup PAC ID 7517094980, 7 clinicians

Practice addresses (Care Compare)

24002 Via Fabricante
Suite 501
Mission Viejo, CA 92691-3934
Phone (949) 454-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33217CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Rehab & Wellness Center, Inc. Chiropractor CurrentSince Jan 25, 2024 Accepting new patients

Locations

24002 Via Fabricante
Ste 501
Mission Viejo, CA 92691
Phone (949) 454-8811

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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1104219690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD",
            "address_2": "SUITE 107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154013",
            "telephone_number": "562-280-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD",
            "address_2": "SUITE 107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154013",
            "telephone_number": "562-280-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.