Jack Everett Downhill Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A50066 Issued in CA

Practice address

3031 S Denison Ave
San Pedro, CA 90731-6703

Phone

(323) 379-3611

NPI assigned

Nov 9, 2006

Last updated

Sep 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Psychiatry

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Behavioral Health Centers of California Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valencia, CA
  • NPI 1669124996

  Psychiatry

  Medicare reassignment NPD
• Dr. Sanchez Marriage and Family Therapy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valencia, CA
  • NPI 1457915423
  NPD
• Spark Physician Assistant Services, Inc.

  dba Spark Psychedelic Therapy

  • Psychiatry Physician
  • San Pedro, CA
  • NPI 1760093454
  NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1467522813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-6176",
            "fax_number": "503-494-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 S DENISON AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316703",
            "telephone_number": "323-379-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "NSUH-Dept of Psychiatry",
            "address_2": "300 Community Drive",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "11030",
            "country_code": "US",
            "telephone_number": "516-562-3051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-6176",
            "fax_number": "501-494-6152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOWNHILL",
        "first_name": "JACK",
        "middle_name": "EVERETT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD180816",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "198053",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A50066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Donatien
• Gerard Donayre, MPT, OCS
• Dessire Douglas
• Marguerite Joanne Doumak, MFT
• Diana Louise Dowds, MFT
• Dr Mona Shah Professional Corporation
• Dr. Jacqueline Cootes, DDS Inc.
• Dr. Jose Javier Juarez, Psy.D., Clinical Psychologist, Apc
• Tiffany Anne Dragovich
• Timothy Dreher, MA, LMFT

• Psychiatry Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.