Individual provider Active NPI

Jamie C Fertal, D.O.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Irvine, CA
National Provider Identifier
1447456769
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
20A11250 Issued in CA
Practice address
1000 Fivepoint
Irvine, CA 92618-2377
Phone
(949) 671-4673
Fax
(949) 671-4329
NPI assigned
Jun 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 20A11250 CA Primary

Addresses

Primary practice location

1000 Fivepoint
Irvine, CA 92618-2377

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185

Other names 1

  • Jamie B Capasso Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jfertal1373015@oc.providencedirect.org
Direct Messaging Address direct@cityofhope.direct-ci.com Direct 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110615000561 CA Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Geriatric Medicine 2567649700 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1000 Fivepoint
Irvine, CA 92618-2377
Phone (949) 671-4673

Hospital & facility affiliations

  • City of Hope Helford Clinical Research Hospital Hospital, Duarte, CA, CCN 050146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11250CAMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
UC Regents CurrentSince Jun 15, 2011 Accepting new patients
The Regents of the University of California-Irvine CurrentSince Jun 15, 2011 Accepting new patients
City of Hope Medical Foundation CurrentSince Jun 3, 2023 Accepting new patients
UC Regents Current Accepting new patients
Providence Medical Foundation CurrentSince Dec 11, 2017 Accepting new patients
UC Regents CurrentSince Jun 15, 2011 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1000 Fivepoint
Irvine, CA 92618
Phone (888) 333-4673

1601 Avocado Ave
Newport Beach, CA 92660
Phone (949) 763-2204

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

1000 W La Veta Ave
Orange, CA 92868
Phone (714) 446-5632

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

Interoperability endpoints

  • Direct secure messaging: rrochester144062@cityofhope.direct-ci.com
  • Direct secure messaging: jfertal1373015@oc.providencedirect.org
  • Direct secure messaging: direct@cityofhope.direct-ci.com

Organizations & group practices 8

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": "1182643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1447456769",
    "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": "1000 FIVEPOINT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182377",
            "telephone_number": "949-671-4673",
            "fax_number": "949-671-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERTAL",
        "first_name": "JAMIE",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-24",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "20A11250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfertal1373015@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1000 W La Veta Ave",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928684304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Fivepoint",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926182377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "CAPASSO",
            "middle_name": "B",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.