Ed Santos Jesalva, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G058063 Issued in CA

Practice address

2659 Townsgate Rd
Suite 209
Westlake Village, CA 91361-2710

Phone

(805) 374-1120

Fax

(805) 374-1124

NPI assigned

Feb 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 18, 2021 through Jul 18, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDGAAA/Endpoint/IDGAAA

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.

• Ed Jesalva M.D.

  • Psychiatry Physician
  • Westlake Village, CA
  • NPI 1275791980
  NPD (past) Authorized official

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1215075817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 TOWNSGATE RD",
            "address_2": "SUITE 209",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612710",
            "telephone_number": "805-374-1120",
            "fax_number": "805-374-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 TOWNSGATE RD",
            "address_2": "SUITE 209",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612710",
            "telephone_number": "805-374-1120",
            "fax_number": "805-374-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESALVA",
        "first_name": "ED",
        "middle_name": "SANTOS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G058063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMC PROVIDER NUMBER",
            "identifier": "ZER60515",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Jekogian
• Adam Jelloian
• Jennifer Brady Licensed Clinical Social Worker PC
• Amanda Farrell Jennings, M.F.T.
• Susan Jerian, M.D.
• Kiana Jimenez
• John a Lee MD a Medical Corporation
• John F Grauch MD a Professional Corporation
• Calle Johnson, ATC
• Carol A Johnson, M.A., LMFT

• Psychiatry Physician in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.