Individual provider Active NPI

Mandeep Jassal, M.D., M.P.H.

  • Pediatric Pulmonology Physician
  • Los Angeles, CA
National Provider Identifier
1194923458
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
D64800 Issued in MD
Practice address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone
(323) 361-5603
Fax
(323) 361-3515
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X D64800 MD 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 90028-7901
Phone (323) 361-2337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20121113000542 MD Practitioner - Pediatric Medicine 2860673761 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D64800MDMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Pediatric Pulmonology CurrentSince Nov 1, 2012 Accepting new patients
Johns Hopkins University Current Accepting new patients
Kennedy Krieger Associates CurrentSince Jul 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Nov 1, 2012 Accepting new patients
Kennedy Krieger Associates CurrentSince Jul 1, 2020 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1741 Ashland Ave
Ste 646
Baltimore, MD 21205

200 N Wolfe St
Lowr
Baltimore, MD 21287
Phone (410) 955-2049

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

601 N Caroline St
Baltimore, MD 21287
Phone (410) 955-5080

Interoperability endpoints

  • Direct secure messaging: mjassal35582@direct.hopkinsmedicine.org

Organizations & group practices 7

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1194923458",
    "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": "900287901",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        },
        {
            "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": "323-361-5603",
            "fax_number": "323-361-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASSAL",
        "first_name": "MANDEEP",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MD",
            "license": "D64800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.