Active NPI
Elizabeth Paula Jivan, PA-C
- Physician Assistant
- Anaheim, CA
National Provider Identifier
1447814652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 56832
- Practice address
- 429 S Shields Dr
Anaheim, CA 92804-2021 - Phone
- (714) 225-3452
- NPI assigned
- Apr 24, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | |||
| Surgical Physician Assistant | 363AS0400X | |||
| Physician Assistant | 363A00000X | 56832 | CA | Primary |
Addresses
Primary practice location
429 S Shields Dr
Anaheim, CA 92804-2021
Mailing address
429 S Shields Dr
Anaheim, CA 92804-2021
Phone (714) 225-3452
Other practice location 1
1000 S Fremont Ave Bldg A-11
Alhambra, CA 91803-8800
Phone (626) 457-4240
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Orange, CA
- NPI 1740214733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1447814652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 S SHIELDS DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928042021",
"telephone_number": "714-225-3452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "429 S SHIELDS DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928042021",
"telephone_number": "714-225-3452"
}
],
"practiceLocations": [
{
"address_1": "1000 S Fremont Ave Bldg A-11",
"address_purpose": "LOCATION",
"city": "Alhambra",
"state": "CA",
"postal_code": "918038800",
"country_code": "US",
"telephone_number": "626-457-4240",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JIVAN",
"first_name": "ELIZABETH",
"middle_name": "PAULA",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-24",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "56832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.