Individual provider Active NPI

Jasreena Nijjar, M.D

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1104221704
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A156297 Issued in CA
Practice address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone
(888) 631-2452
Fax
(323) 361-8988
NPI assigned
Oct 27, 2014
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A156297 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Los Angeles, CA 90027-6062

Mailing address

3701 Wilshire Blvd Ste 600
Los Angeles, CA 90010-2814
Phone (323) 361-3550

Other practice location 1

4422 3rd Ave
Bronx, NY 10457-2545
Phone (718) 960-9331

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123003285 CA Practitioner - EndocrinologyPractitioner - Pediatric Medicine 1951619501 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A156297CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 13, 2023 Accepting new patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Nov 1, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 13, 2023 Accepting new patients
Confermed of California PC CurrentSince May 19, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Children's Hospital Los Angeles Past Accepting new patients
Confermed PC Pediatrics Past Accepting new patients
Chla Teaching Clinics LLC PastSince Apr 1, 2021 Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184

101 Academy
Ste 100
Irvine, CA 92617
Phone (860) 323-0172

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

11 Silver St
Unit 856
Middletown, CT 06457

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1104221704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 WILSHIRE BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102814",
            "telephone_number": "323-361-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "888-631-2452",
            "fax_number": "323-361-8988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4422 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104572545",
            "country_code": "US",
            "telephone_number": "718-960-9331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIJJAR",
        "first_name": "JASREENA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A156297",
            "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": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.