Individual provider Active NPI

Frank Luis Jimenez, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1184018566
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52382 Issued in CA
Practice address
3612 1/2 E 1St St
Los Angeles, CA 90063-2326
Phone
(323) 264-7796
NPI assigned
Mar 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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 52382 CA Primary

Addresses

Primary practice location

3612 1/2 E 1St St
Los Angeles, CA 90063-2326

Mailing address

3612 1/2 E 1St St
Los Angeles, CA 90063-2326
Phone (323) 264-7796

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
I20160519002310 CA Practitioner - Physician Assistant 9335438951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
California Wound Healing Medical Group Inc.Group PAC ID 7315033198, 21 clinicians

Practice addresses (Care Compare)

100 E Huntington Dr
Alhambra, CA 91801-1022
Phone (323) 264-7796

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52382CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Edge Medical Group - Ca CurrentSince Feb 2, 2026 Accepting new patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

Locations

100 E Huntington Dr
Ste 203
Alhambra, CA 91801

Organizations & group practices 3

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1184018566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 1/2 E 1ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900632326",
            "telephone_number": "323-264-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 1/2 E 1ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900632326",
            "telephone_number": "323-264-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "FRANK",
        "middle_name": "LUIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.