Jesse Joseph Licuanan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A87633 Issued in CA

Practice address

3650 South St Ste 403
Lakewood, CA 90712-1504

Phone

(562) 531-0377

NPI assigned

May 10, 2006

Last updated

Jan 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Internal MedicineAlso: General Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Highmark Home Health, Inc Home health agency, West Covina, CA, CCN 058261
• Uci Health-Lakewood Hospital, Lakewood, CA, CCN 050581
• Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
• Uci Health-Orange Hospital, Orange, CA, CCN 050348
• Kindred Hospital Paramount Inpatient rehabilitation facility, Paramount, CA, CCN 05TA46
• Kindred Hospital Paramount Long-term care hospital, Paramount, CA, CCN 052046

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Careconnectmd Ca PC

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1366063125

  Multi-Specialty

  Medicare reassignment NPD
• Jesse J Licuanan MD a Medical Corporation

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1114218559
  Authorized official Same address or phone
• Prohealth Partners a Medical Group Inc

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1447382411

  Multi-Specialty

  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1821121542

  Multi-Specialty

  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394

  Multi-Specialty

  NPD
• Anaheim Global Medical Center, Inc

  dba Anaheim Global Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1790778488
  NPD (past)
• CHI Imaging Inc

  • Physiological Laboratory
  • Los Angeles, CA
  • NPI 1295782001
  NPD (past)
• Dignity Health

  dba St. Mary Medical Center

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  NPD (past)
• GN Medical Associates, Inc.

  dba Gerinet Medical Associates

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1275576522

  Multi-Specialty

  NPD (past)
• Los Alamitos Medical Center, Inc.

  dba Los Alamitos Medical Center

  • Psychiatric Hospital Unit
  • Los Alamitos, CA
  • NPI 1497780084
  NPD (past)
• Pih Health Downey Hospital

  dba Downey Regional Medical Center

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1265433551
  NPD (past)

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

• Highmark Home Health, Inc

  • Home Health Agency
  • West Covina, CA
  • NPI 1982663407
  Care Compare affiliation
• KND Real Estate 40, LLC

  dba Kindred Hospital Paramount

  • Long Term Care Hospital
  • Paramount, CA
  • NPI 1093275786

  Long-term care hospital

  Care Compare affiliation
• KND Real Estate 40, LLC

  dba Kindred Hospital Paramount (Acute Rehab Unit)

  • Rehabilitation Hospital
  • Paramount, CA
  • NPI 1578159661

  Inpatient rehabilitation facility

  Care Compare affiliation
• Long Beach Memorial Medical

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1962442012
  Care Compare affiliation
• University of California Irvine

  dba UCI Health Lakewood

  • General Acute Care Hospital
  • Lakewood, CA
  • NPI 1184655581
  Care Compare affiliation
• University of California Irvine

  dba University of California Irvine - Cac Urgent Care

  • Urgent Care Clinic/Center
  • Irvine, CA
  • NPI 1518739309

  Hospital

  Care Compare affiliation
• University of California Irvine

  dba Uci Health

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  Care Compare affiliation

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1396795514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 403",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121504",
            "telephone_number": "562-531-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 403",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121504",
            "telephone_number": "562-531-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICUANAN",
        "first_name": "JESSE",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A-87633",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A87633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Alan Lin M D, Inc
• Carrie Ann Levinson, LCSW
• Kelsey Lewis
• Thimbi Lewis
• Connie Li
• Andrew James Lien
• Brandon Lim
• Jaycee Lim, DMD
• Lin Ros Best Home Care No 2 (Lin Ros Best Home Care)
• Sandra S Lin-Lee, O.D.

• Internal Medicine Physician in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.