Individual provider Active NPI

Jamaica Alicia Gendel, PA-C

  • Physician Assistant
  • Beverly Hills, CA
National Provider Identifier
1114683422
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
201 S Lasky Dr
Beverly Hills, CA 90212-3610
Phone
(310) 424-2000
NPI assigned
Nov 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

201 S Lasky Dr
Beverly Hills, CA 90212-3610

Mailing address

133 S Doheny Dr Apt 305
Los Angeles, CA 90048-2941
Phone (408) 439-3282

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
I20231116001879 CA Practitioner - Physician Assistant 5597112292 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians
Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians

Practice addresses (Care Compare)

19346 Nordhoff St
Northridge, CA 91324-2415
Phone (818) 727-2040

20201 Rinaldi St
Suite 110
Northridge, CA 91326-4938
Phone (747) 444-4901

23341 Mulholland Dr
Woodland Hills, CA 91364-2734
Phone (818) 637-0048

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

2944 Tapo Canyon Rd
Suite a
Simi Valley, CA 93063-0903
Phone (805) 306-5990

620 E Janss Rd
Thousand Oaks, CA 91360-5113
Phone (805) 495-6866

6440 Platt Ave
West Hills, CA 91307-3216
Phone (818) 946-1103

701 N Wendy Dr
Newbury Park, CA 91320-3066
Phone (805) 375-4400

806 New Los Angeles Ave
Moorpark, CA 93021-3608
Phone (805) 334-8650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
60554CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Skinpeccable Inc. Current Accepting new patients
Brentview Medical Inc. CurrentSince Sep 19, 2023 Accepting new patients
BVM Therapy Inc. Past Accepting new patients
Carbon Health Medical Group of California PC Past Accepting new patients
Carbon Health Primary Care of California PC PastSince Apr 5, 2021 Accepting new patients

Locations

11611 San Vicente Blvd
Ste GF1
Los Angeles, CA 90049
Phone (310) 820-0013

11611 San Vicente Blvd
Los Angeles, CA 90049
Phone (310) 447-6060

Organizations & group practices 8

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": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1114683422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 S DOHENY DR APT 305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900482941",
            "telephone_number": "408-439-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S LASKY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123610",
            "telephone_number": "310-424-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDEL",
        "first_name": "JAMAICA",
        "middle_name": "ALICIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.