Individual provider Active NPI

Jolene Elizabeth Collins, MD

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1134427495
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A116007 Issued in CA
Practice address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone
(323) 361-2534
NPI assigned
Mar 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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 A116007 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Los Angeles, CA 90027-6062

Mailing address

6430 W Sunset Blvd
Suite 600
Los Angeles, CA 90028-7900
Phone (323) 361-2534

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
I20120712000344 CA Practitioner - Pediatric Medicine 0749445039 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Apr 24, 2013 Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients

Locations

4650 W Sunset Blvd
#76
Los Angeles, CA 90027
Phone (323) 669-2113

4650 W Sunset Blvd
Stop 76
Los Angeles, CA 90027
Phone (323) 361-6161

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1134427495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 W SUNSET BLVD",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287900",
            "telephone_number": "323-361-2534"
        },
        {
            "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": "323-361-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JOLENE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A116007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.