Jon David Beserra II, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95001053 Issued in CA

Practice address

25825 Vermont Ave
Harbor City, CA 90710-3518

Phone

(310) 325-5111

NPI assigned

Feb 12, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. John David Beserra II Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Vascular Access Care IncGroup PAC ID 2860839032, 4 clinicians

SCQ Anesthesia a Professional Nursing CorporationGroup PAC ID 9436520814, 15 clinicians

Innovative Minimally Invasive Imaging and Therapeutics, IncGroup PAC ID 9638458003, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBCJAA

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.

• Innovative Minimally Invasive Imaging & Therapeutics, Inc

  • Vascular & Interventional Radiology Physician
  • Rancho Cucamonga, CA
  • NPI 1952758849
  Medicare reassignment Care Compare group NPD
• SCQ Anesthesia a Professional Nursing Corporation

  • Certified Registered Nurse Anesthetist
  • Tarzana, CA
  • NPI 1689381105

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Pacific Vascular Access Care, Inc

  • Vascular & Interventional Radiology Physician
  • Downey, CA
  • NPI 1629846670
  Medicare reassignment Care Compare group
• Digestive Health Associates of Southern California

  • Certified Registered Nurse Anesthetist
  • Santa Monica, CA
  • NPI 1639604747

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Marquee Anesthesia Consultants Inc

  • Certified Registered Nurse Anesthetist
  • Redlands, CA
  • NPI 1760942619

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Digestive Health Associates of Southern California

  • Anatomic Pathology & Clinical Pathology Physician
  • Santa Monica, CA
  • NPI 1043098619
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hawthorne, CA
  • NPI 1164914115
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• San Fernando Valley Vascular Group a Medical Corporation

  • Specialist
  • Tarzana, CA
  • NPI 1518014463
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1336605682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8073 PAGE ST",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906213842",
            "telephone_number": "702-469-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-325-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESERRA",
        "first_name": "JON",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001053",
            "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": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "BESERRA",
            "middle_name": "DAVID",
            "prefix": "MR.",
            "suffix": "II",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Bio-Medical Applications of California, Inc.

• Certified Registered Nurse Anesthetist in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.