Individual provider Active NPI

Julie Meyoung Ma, MD

  • Internal Medicine Physician
  • Pacific Palisades, CA
National Provider Identifier
1306865688
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G84767 Issued in CA
Practice address
15200 W Sunset Blvd Ste 107
Pacific Palisades, CA 90272-3620
Phone
(310) 459-7736
Fax
(310) 230-0284
NPI assigned
Jul 18, 2006
Last updated
Dec 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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 G84767 CA Primary

Addresses

Primary practice location

15200 W Sunset Blvd Ste 107
Pacific Palisades, CA 90272-3620

Mailing address

15200 W Sunset Blvd Ste 107
Pacific Palisades, CA 90272-3620
Phone (310) 459-7736

Other identifiers 1

IdentifierTypeStateIssuer
00G751910MedicaidCA

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
I20040807000259 CA Practitioner - Internal Medicine 6507838968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Pennsylvania, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Palisades Medical Group IncGroup PAC ID 1153393517, 2 clinicians

Practice addresses (Care Compare)

11620 Wilshire Blvd
Suite 600
Los Angeles, CA 90025-1776
Phone (310) 459-7736

2730 Wilshire Blvd
Suite 301
Santa Monica, CA 90403-4749
Phone (310) 459-7736

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

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 Medicine

State licenses

LicenseStateTypeSpecialty
G84767CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Palisades Medical Group Inc. CurrentSince Jul 1, 2004 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

11620 Wilshire Blvd
Ste 600
Los Angeles, CA 90025
Phone (310) 459-7736

2934 N Beverly Glen Cir
Ste 445
Los Angeles, CA 90077

15200 W Sunset Blvd
Ste 107
Pacific Palisades, CA 90272
Phone (310) 459-7736

2730 Wilshire Blvd
Ste 301
Santa Monica, CA 90403
Phone (310) 459-7736

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1306865688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 W SUNSET BLVD STE 107",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723620",
            "telephone_number": "310-459-7736",
            "fax_number": "310-230-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 W SUNSET BLVD STE 107",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723620",
            "telephone_number": "310-459-7736",
            "fax_number": "310-230-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "JULIE",
        "middle_name": "MEYOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G84767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G751910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

Verify at the official NPI Registry.