Individual provider Active NPI

Jacob Schwartz, PA-C

  • Medical Physician Assistant
  • Panorama City, CA
National Provider Identifier
1336897040
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
60894 Issued in CA
Practice address
14860 Roscoe Blvd Ste 200
Panorama City, CA 91402-4683
Phone
(310) 553-5203
NPI assigned
Mar 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PA60894 CA
Hospitalist Physician 208M00000X PA60894 CA
Medical Physician Assistant 363AM0700X 60894 CA Primary

Addresses

Primary practice location

14860 Roscoe Blvd Ste 200
Panorama City, CA 91402-4683

Mailing address

12665 Village LN Apt 2301
Playa Vista, CA 90094-2832

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
I20230406000663 CA Practitioner - Physician Assistant 6103291083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriheal PCGroup PAC ID 7416386800, 13 clinicians

Practice addresses (Care Compare)

9640 Venice Blvd
Culver City, CA 90232-2626
Phone (310) 963-0365

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60894CAMDHospitalist Physician
60894CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geriheal PC Internal Medicine CurrentSince Aug 17, 2025 Accepting new patients

Locations

9808 Venice Blvd
Ph
Culver City, CA 90232
Phone (310) 733-4171

9640 Venice Blvd
Culver City, CA 90232
Phone (310) 803-6013

1715 S Cedar Ave
Fresno, CA 93702
Phone (559) 237-8377

4164 N 4th Ave
Sn Bernrdno, CA 92407
Phone (909) 886-6786

Interoperability endpoints

  • Direct secure messaging: jschwartz1358535@direct.uclahealth.org
  • FHIR API: https://api.platform.athenahealth.com/25529/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1336897040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 VILLAGE LN APT 2301",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14860 ROSCOE BLVD STE 200",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024683",
            "telephone_number": "310-553-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "PA60894",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "PA60894",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "60894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.