Individual provider Active NPI

Jennifer Kim Loomis, D.O.

  • Family Medicine Physician
  • Los Alamitos, CA
National Provider Identifier
1215136940
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2OA9418 Issued in CA
Practice address
3801 Katella Ave
222
Los Alamitos, CA 90720-3338
Phone
(562) 296-5528
Fax
(562) 296-8770
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2OA9418 CA Primary

Addresses

Primary practice location

3801 Katella Ave
222
Los Alamitos, CA 90720-3338

Mailing address

3801 Katella Ave
222
Los Alamitos, CA 90720-3338
Phone (562) 296-5528

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
I20100621000849 CA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 2062543986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3851 Katella Ave
Suite 275
Los Alamitos, CA 90720-3377
Phone (562) 296-5528

Hospital & facility affiliations

  • Grace Home Health Care Home health agency, Long Beach, CA, CCN 557613
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2OA9418CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Careconnectmd Ca PC Family Medicine CurrentSince Jun 24, 2022 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Feb 8, 2016 Accepting new patients
Prohealth Partners a Medical Group Inc Family Medicine CurrentSince Feb 8, 2016 Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Prohealth Partners, a Medical Group, Inc. Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

12131 Carson St
Hawaiian Gardens, CA 90716
Phone (562) 809-0299

17822 Beach Blvd
Ste 373
Huntington Beach, CA 92647
Phone (714) 848-3333

3840 Woodruff Ave
Ste 202
Long Beach, CA 90808
Phone (562) 296-5528

1045 Atlantic Ave
Ste 511
Long Beach, CA 90813
Phone (562) 595-6770

3851 Katella Ave
Ste 275
Los Alamitos, CA 90720
Phone (562) 296-5528

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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 5

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1215136940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "222",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203338",
            "telephone_number": "562-296-5528",
            "fax_number": "562-296-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "222",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203338",
            "telephone_number": "562-296-5528",
            "fax_number": "562-296-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM LOOMIS",
        "first_name": "JENNIFER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "2OA9418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.