Individual provider Active NPI

Gerald Andrew Todd, PA

  • Medical Physician Assistant
  • Inglewood, CA
National Provider Identifier
1275569113
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA13916 Issued in CA
Practice address
301 N Prairie Ave Ste 230
Inglewood, CA 90301-4509
Phone
(323) 944-0949
Fax
(323) 782-0388
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA13916 CA Primary

Addresses

Primary practice location

301 N Prairie Ave Ste 230
Inglewood, CA 90301-4509

Mailing address

301 N Prairie Ave Ste 230
Inglewood, CA 90301-4509
Phone (323) 944-0949

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060508000304 CA Practitioner - Physician Assistant 3870504715 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13916CAMDSpeech-Language Pathologist
PA13916CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medipro Inc. Past Accepting new patients
Allied Health Solutions Ipa, Inc PastSince Jul 1, 2022 Accepting new patients

Organizations & group practices 3

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1275569113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N PRAIRIE AVE STE 230",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014509",
            "telephone_number": "323-944-0949",
            "fax_number": "323-782-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PRAIRIE AVE STE 230",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014509",
            "telephone_number": "323-944-0949",
            "fax_number": "323-782-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "GERALD",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA13916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.