Individual provider Active NPI

Augustine Pyo

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1255741005
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A139002 Issued in CA
Practice address
12021 Wilmington Ave
BLDG 11, Suite 1000
Los Angeles, CA 90059-3019
Phone
(424) 529-6755
Fax
(424) 338-8984
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A139002 CA Primary

Addresses

Primary practice location

12021 Wilmington Ave
BLDG 11, Suite 1000
Los Angeles, CA 90059-3019

Mailing address

1000 W Carson St # 400
Torrance, CA 90502-2004
Phone (310) 222-2401

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20191227002022 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Family PracticePractitioner - Internal Medicine 6608111281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Family Practice, Internal Medicine
Education
Tufts University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9333 Imperial Hwy
Downey, CA 90242-2812
Phone (800) 923-4040

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

9353 Imperial Hwy
Downey, CA 90242-2812
Phone (562) 657-9000

9449 Imperial Hwy
Downey, CA 90242-2814
Phone (562) 461-3000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Downey Hospital, Downey, CA, CCN 050139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A139002CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Luther King Jr Community Medical Foundation CurrentSince Sep 1, 2020 Accepting new patients
Martin Luther King Jr Community Medical Foundation Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 31, 2022 Accepting new patients
Martin Luther King Jr Community Medical Foundation Internal Medicine Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

2215 W Rosecrans Ave
Ste 22
Compton, CA 90222
Phone (424) 529-6755

135 E Compton Blvd
Compton, CA 90220
Phone (424) 296-3800

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

12021 Wilmington Ave
Bldg 11
Los Angeles, CA 90059
Phone (424) 338-8000

12021 Wilmington Ave
Ste 1000
Los Angeles, CA 90059
Phone (424) 296-3976

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

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.

Hospital & facility affiliations 1

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1255741005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST # 400",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "address_2": "BLDG 11, SUITE 1000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "424-529-6755",
            "fax_number": "424-338-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYO",
        "first_name": "AUGUSTINE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2023-09-26",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A139002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.