Individual provider Active NPI

Jasmina Dukovic, PA-C

  • Physician Assistant
  • Downey, CA
National Provider Identifier
1457021677
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60010 Issued in CA
Practice address
11411 Brookshire Ave Ste 508
Downey, CA 90241-5007
Phone
(562) 923-0706
Fax
(562) 861-2133
NPI assigned
Sep 18, 2021
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60010 CA Primary

Addresses

Primary practice location

11411 Brookshire Ave Ste 508
Downey, CA 90241-5007

Mailing address

PO Box 845996
Los Angeles, CA 90084-5996
Phone (858) 888-7700

Other practice location 1

15111 Whittier Blvd Ste 390
Whittier, CA 90603-3301
Phone (562) 320-8231

Other practice location 2

575 E Hardy St Ste 215
Inglewood, CA 90301-4041
Phone (310) 673-3333

Other practice location 3

3801 Katella Ave Ste 223
Los Alamitos, CA 90720-6904
Phone (562) 449-4183

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
I20211217000260 CA Practitioner - Physician Assistant 6103217641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

23600 Telo Ave
Suite 220
Torrance, CA 90505-4039
Phone (310) 534-8400

3801 Katella Ave
Suite 223
Los Alamitos, CA 90720-6904
Phone (562) 499-4183

3801 Katella Ave
Suite 302
Los Alamitos, CA 90720-3374
Phone (562) 449-4183

575 E Hardy St
Suite 215
Inglewood, CA 90301-4041
Phone (310) 673-3333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60010CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Urology Current Accepting new patients
Paletz Agatstein Urology Medical GRP Inc CurrentSince Oct 1, 2002 Accepting new patients
Urology Institute of the South Bay Current Accepting new patients

Locations

11411 Brookshire Ave
Ste 508
Downey, CA 90241
Phone (562) 823-0706

575 E Hardy St
Ste 215
Inglewood, CA 90301
Phone (310) 673-3333

3801 Katella Ave
Ste 223
Los Alamitos, CA 90720
Phone (562) 449-4183

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

15111 Whittier Blvd
Ste 390
Whittier, CA 90603
Phone (562) 320-8231

Interoperability endpoints

  • Direct secure messaging: jasmina.dukovic.1@3663.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1631923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1457021677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845996",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900845996",
            "telephone_number": "858-888-7700",
            "fax_number": "858-221-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 BROOKSHIRE AVE STE 508",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415007",
            "telephone_number": "562-923-0706",
            "fax_number": "562-861-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15111 Whittier Blvd Ste 390",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906033301",
            "country_code": "US",
            "telephone_number": "562-320-8231",
            "fax_number": "562-861-2133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "575 E Hardy St Ste 215",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903014041",
            "country_code": "US",
            "telephone_number": "310-673-3333",
            "fax_number": "310-673-1714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 Katella Ave Ste 223",
            "address_purpose": "LOCATION",
            "city": "Los Alamitos",
            "state": "CA",
            "postal_code": "907206904",
            "country_code": "US",
            "telephone_number": "562-449-4183",
            "fax_number": "562-861-2133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUKOVIC",
        "first_name": "JASMINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-18",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.