Individual provider Active NPI

Jingbo Huang, MD

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1386955862
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A125465 Issued in CA
Practice address
6041 Cadillac Ave Ste 435
Los Angeles, CA 90034-1702
Phone
(323) 857-3137
Fax
(323) 857-2748
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A125465 CA Primary
Internal Medicine Physician 207R00000X A125465 CA

Addresses

Primary practice location

6041 Cadillac Ave Ste 435
Los Angeles, CA 90034-1702

Mailing address

6041 Cadillac Ave Ste 435
Los Angeles, CA 90034-1702
Phone (323) 857-3137

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20151013000773 CA Practitioner - Internal MedicinePractitioner - Nephrology 2668780834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - West la Hospital, Los Angeles, CA, CCN 050561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125465CAMDMarriage & Family Therapist
A125465CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 31, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 31, 2015 Accepting new patients
California Kidney Specialists Internal Medicine CurrentSince Aug 16, 2015 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

6041 Cadillac Ave
Ste 435
Los Angeles, CA 90034
Phone (323) 857-3137

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5192cc27-2764-47df-a8de-8ad1cf29ade6/

Organizations & group practices 4

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": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1386955862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 CADILLAC AVE STE 435",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900341702",
            "telephone_number": "323-857-3137",
            "fax_number": "323-857-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 CADILLAC AVE STE 435",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900341702",
            "telephone_number": "323-857-3137",
            "fax_number": "323-857-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "JINGBO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A125465",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A125465",
            "primary": false
        }
    ],
    "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": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.