Individual provider Active NPI

Elena Yeroushalmi, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1467920496
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56129 Issued in CA
Practice address
6507 Moore Dr
Los Angeles, CA 90048-5325
Phone
(310) 218-8821
NPI assigned
Nov 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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 56129 CA Primary

Addresses

Primary practice location

6507 Moore Dr
Los Angeles, CA 90048-5325

Mailing address

6507 Moore Dr
Los Angeles, CA 90048-5325
Phone (310) 218-8821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56129CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1467920496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 MOORE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485325",
            "telephone_number": "310-218-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 MOORE DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485325",
            "telephone_number": "310-218-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEROUSHALMI",
        "first_name": "ELENA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.