Individual provider Active NPI

Emilia Velma Ivans, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1174979090
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53459 Issued in CA
Practice address
6801 Park Ter Ste 400
Los Angeles, CA 90045-9212
Phone
(310) 665-7200
Fax
(844) 720-7885
NPI assigned
May 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3567 CT
Surgical Physician Assistant 363AS0400X 3567 CT
Physician Assistant 363A00000X 53459 CA Primary

Addresses

Primary practice location

6801 Park Ter Ste 400
Los Angeles, CA 90045-9212

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 665-7200

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
I20210604000761 CA Practitioner - Physician Assistant 5193018893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

1601 Dove St
Suite 275
Newport Beach, CA 92660-1431
Phone (310) 665-7200

2400 E Katella Ave
Suite 400
Anaheim, CA 92806-5972
Phone (310) 231-2121

3330 Lomita Blvd
Torrance, CA 90505-5002
Phone (310) 517-4765

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 823-8911

6801 Park Ter
Los Angeles, CA 90045-9212
Phone (310) 655-7200

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3567CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Hospital Incorporated Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eivans237189@direct.cshs.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1174979090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "310-665-7200",
            "fax_number": "844-720-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TER STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900459212",
            "telephone_number": "310-665-7200",
            "fax_number": "844-720-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANS",
        "first_name": "EMILIA",
        "middle_name": "VELMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3567",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3567",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.