Individual provider Active NPI

Orena Massachi, PA

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1417638115
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63743 Issued in CA
Practice address
1127 Wilshire Blvd Ste 800
Los Angeles, CA 90017-3909
Phone
(213) 839-1119
Fax
(213) 839-1120
NPI assigned
Jul 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA63743 CA Primary

Addresses

Primary practice location

1127 Wilshire Blvd Ste 800
Los Angeles, CA 90017-3909

Mailing address

224 N Fair Oaks Ave Ste 300
Pasadena, CA 91103-3618
Phone (626) 696-1400

Other practice location 1

9808 Venice Blvd Ste 706
Culver City, CA 90232
Phone (323) 932-9880

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
I20240429000168 CA Practitioner - Physician Assistant 0143660803 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Next Phase Medical PCGroup PAC ID 5890271951, 3 clinicians

Practice addresses (Care Compare)

11825 Major St
Suite 107
Culver City, CA 90230-6356
Phone (310) 915-6100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA63743CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Algos Inc. a Medical Corporation CurrentSince Mar 2, 2024 Accepting new patients
Algos Inc., a Medical Corporation Single Specialty CurrentSince Mar 2, 2024 Accepting new patients
Algos Inc., a Medical Corporation Single Specialty Past Accepting new patients
Algos Inc., a Medical Corporation Single Specialty Past Accepting new patients
Ac and CS Single Specialty Past Accepting new patients

Locations

9808 Venice Blvd
Ste 706
Culver City, CA 90232
Phone (310) 839-3200

1127 Wilshire Blvd
Ste 800
Los Angeles, CA 90017
Phone (213) 241-7250

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1417638115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N FAIR OAKS AVE STE 300",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911033618",
            "telephone_number": "626-696-1400",
            "fax_number": "626-696-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173909",
            "telephone_number": "213-839-1119",
            "fax_number": "213-839-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9808 Venice Blvd Ste 706",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "90232",
            "country_code": "US",
            "telephone_number": "323-932-9880",
            "fax_number": "323-932-9829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSACHI",
        "first_name": "ORENA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.