NPIMap

Individual provider Active NPI

Jeffrey Ashraf Hammoudeh, M.D., D.D.S.

  • Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1285715086
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A94991 Issued in CA
Practice address
4650 W Sunset Blvd
Ms# 96
Los Angeles, CA 90027-6062
Phone
(323) 669-2154
Fax
(323) 669-4106
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X A94991 CA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X A94991 CA

Addresses

Primary practice location

4650 W Sunset Blvd
Ms# 96
Los Angeles, CA 90027-6062

Mailing address

6430 W Sunset Blvd
Suite 600
Los Angeles, CA 90028-7901
Phone (323) 669-2337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120410000047 CA Practitioner - Pediatric Medicine 7416118989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-8408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94991CAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Jan 29, 2012 Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients
Usc Care Medical Group, Inc Past Accepting new patients
Glendale Surgical Associates, LP Oral and Maxillofacial Surgery Past Accepting new patients
Glendale Surgical Associates, LP Oral and Maxillofacial Surgery Past Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients

Locations

4650 W Sunset Blvd
#96
Los Angeles, CA 90027
Phone (323) 361-2154

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jhammoudeh350332@oc.providencedirect.org

Organizations & group practices 10

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1285715086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 W SUNSET BLVD",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287901",
            "telephone_number": "323-669-2337",
            "fax_number": "323-644-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MS# 96",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-669-2154",
            "fax_number": "323-669-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOUDEH",
        "first_name": "JEFFREY",
        "middle_name": "ASHRAF",
        "credential": "M.D., D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A94991",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "A94991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.