Individual provider Active NPI

Michael Jason Hall, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1396744850
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A82333 Issued in CA
Practice address
1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone
(323) 993-7500
Fax
(323) 308-4015
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A82333 CA Primary

Addresses

Primary practice location

1625 Schrader Blvd
Los Angeles, CA 90028-6213

Mailing address

1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 993-7500

Other identifiers 1

IdentifierTypeStateIssuer
00A823330MedicaidCA

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
I20040618001329 CA Practitioner - Family Practice 2062497688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Angeles LGBT CenterGroup PAC ID 8729975453, 29 clinicians

Practice addresses (Care Compare)

1625 Schrader Blvd
FL 3
Los Angeles, CA 90028-6213
Phone (323) 993-7400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82333CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles LGBT Center CurrentSince Nov 10, 2003 Accepting new patients
Los Angeles LGBT Center CurrentSince Nov 10, 2003 Accepting new patients

Locations

1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400

1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400

3055 Wilshire Blvd
Ste 360
Los Angeles, CA 90010
Phone (323) 466-4372

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mjasonhall@lalgbtc.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1396744850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7500",
            "fax_number": "323-308-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7500",
            "fax_number": "323-308-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MICHAEL",
        "middle_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A82333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A823330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.