Individual provider Active NPI

Clayton B Dejong, MD

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1467466409
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A42912 Issued in CA
Practice address
300 Redondo Ave
Long Beach, CA 90814-2651
Phone
(562) 433-7496
Fax
(562) 987-9206
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A42912 CA Primary

Addresses

Primary practice location

300 Redondo Ave
Long Beach, CA 90814-2651

Mailing address

300 Redondo Ave
Long Beach, CA 90814-2651

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
I20100504000466 CA Practitioner - Internal Medicine 3072694777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1985
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)

300 Redondo Ave B
Long Beach, CA 90814-2651
Phone (562) 433-7496

Hospital & facility affiliations

  • Hygieia Home Health Inc Home health agency, Lakewood, CA, CCN 557541
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • St Mary Medical Center Hospital, Long Beach, CA, CCN 050191
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Internal Medicine Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. Internal Medicine CurrentSince Jun 1, 1995 Accepting new patients
Careconnectmd Ca PC CurrentSince Jun 24, 2022 Accepting new patients
Prohealth Partners a Medical Group Inc Internal Medicine CurrentSince Jun 1, 1995 Accepting new patients
Prohealth Partners a Medical Group Inc Internal Medicine Past Accepting new patients
Dignity Health Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

300 Redondo Ave
#B
Long Beach, CA 90814

300 Redondo Ave
Long Beach, CA 90814
Phone (562) 433-7496

300 Redondo Ave
Ste B
Long Beach, CA 90814
Phone (562) 433-7496

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1467466409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908142651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908142651",
            "telephone_number": "562-433-7496",
            "fax_number": "562-987-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONG",
        "first_name": "CLAYTON",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A42912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.