Jay H Takata, PA

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

PA15700 Issued in CA

Practice address

12401 Washington Blvd
Whittier, CA 90602-1006

Phone

(562) 698-0811

Fax

(818) 587-2493

NPI assigned

Jun 18, 2006

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 identifiers 2

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

George Washington University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jay.takata.p56@direct.medcor.nextgenshare.com
• Direct secure messaging: jay.takata.p1@direct.cdsdp.nextgenshare.com

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.

• Exer Medical Corporation

  dba Exer Urgent Care

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group NPD
• Torrance Health Association Inc

  dba Torrance Memorial Physician Network

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1083903124
  Medicare reassignment Care Compare group NPD
• Can Emergency Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Panorama City, CA
  • NPI 1265810006
  Medicare reassignment
• Culver Emergency Medical Group

  • Emergency Medicine Physician
  • Culver City, CA
  • NPI 1699907923
  Medicare reassignment
• Intercommunity Emergency Medical Group

  • Emergency Medicine Physician
  • Whittier, CA
  • NPI 1871535286
  Medicare reassignment
• Can Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1386018356
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1346285962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "800-506-6895",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021006",
            "telephone_number": "562-698-0811",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKATA",
        "first_name": "JAY",
        "middle_name": "H",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "PA15700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA15700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00282752",
            "state": "CA"
        }
    ],
    "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": []
}

• Korynn Sycip
• Fatima Tabasum Syed, AMFT
• Sylvia L. Garcia M.D. Inc.
• Ravikanth Reddy Tadi, M.D.
• James H Tagle
• Ken Takeda
• Joseph Talamantes
• Esperanza Talavera
• Cynthia Talmich, LCSW
• Jennifer Tam, LCSW

• Emergency Medicine Physician in Whittier, CA
• Providers in Whittier, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.