Individual provider Active NPI

Beth Landa, PAC

  • Physician Assistant
  • Duarte, CA
National Provider Identifier
1356458137
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12730 Issued in CA
Practice address
1500 Duarte Rd
Duarte, CA 91010-3012
Phone
(626) 359-8111
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA12730 CA
Physician Assistant 363A00000X PA12730 CA Primary

Addresses

Primary practice location

1500 Duarte Rd
Duarte, CA 91010-3012

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185

Other identifiers 4

IdentifierTypeStateIssuer
PA12730MedicaidCA
GR0100430OtherCAGROUP MEDICAL
1902846306OtherCAGROUP NPI
W18762OtherCAGROUP MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com CITY OF HOPE MEDICAL FOUNDATION

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
I20110224000779 CA Practitioner - Physician Assistant 3476734336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

1500 E Duarte Rd
Duarte, CA 91010-3012

209 Fair Oaks Ave
South Pasadena, CA 91030-1814
Phone (626) 396-2900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Oct 22, 2011 Accepting new patients
City of Hope Medical Group, Inc. Current Accepting new patients
Usc Care Medical Group, Inc CurrentSince Oct 22, 2011 Accepting new patients
City of Hope Medical Foundation CurrentSince Sep 24, 2012 Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
California Cancer Specialists Medical Group Inc Past Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

6939 Palm Ct
Riverside, CA 92506
Phone (760) 416-4832

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

23861 McBean Pkwy
Ste B14
Valencia, CA 91355
Phone (661) 799-1999

Interoperability endpoints

  • Direct secure messaging: direct@cityofhope.direct-ci.com
  • Direct secure messaging: blanda9610@cityofhope.direct-ci.com

Organizations & group practices 7

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 1

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1356458137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103012",
            "telephone_number": "626-359-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDA",
        "first_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12730",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA12730",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAL",
            "identifier": "GR0100430",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1902846306",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "W18762",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "1500 Duarte Rd",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910103012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

Verify at the official NPI Registry.