Individual provider Active NPI

Jerome H. Jones, MD

  • Pediatrics Physician
  • Huntington Beach, CA
National Provider Identifier
1205833688
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C28381 Issued in CA
Practice address
19066 Magnolia St.
Huntington Beach, CA 92646
Phone
(714) 968-0068
Fax
(714) 378-2188
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 C28381 CA Primary

Addresses

Primary practice location

19066 Magnolia St.
Huntington Beach, CA 92646

Mailing address

1665 Scenic Ave.
Suite 100
Costa Mesa, CA 92626
Phone (714) 968-0068

Other identifiers 1

IdentifierTypeStateIssuer
00C283810OtherCAMEDI CAL

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
I20130213000310 CA Practitioner - Pediatric Medicine 6204080518 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1665 Scenic Ave
Ste 100
Costa Mesa, CA 92626
Phone (714) 436-4444

19066 Magnolia St
Huntington Beach, CA 92646
Phone (714) 378-2225

17071 Springdale St
Huntington Beach, CA 92649
Phone (714) 377-9333

Organizations & group practices 5

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1205833688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 SCENIC AVE.",
            "address_2": "SUITE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "714-968-0068",
            "fax_number": "714-378-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19066 MAGNOLIA ST.",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92646",
            "telephone_number": "714-968-0068",
            "fax_number": "714-378-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JEROME",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C28381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "00C283810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.