NPIMap

Individual provider Active NPI

Jason Matthew Fletcher, D.O.

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1487810131
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A12163 Issued in CA
Practice address
2880 Atlantic Ave
Suite 110
Long Beach, CA 90806-1714
Phone
(562) 424-4404
NPI assigned
Aug 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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 20A12163 CA Primary

Addresses

Primary practice location

2880 Atlantic Ave
Suite 110
Long Beach, CA 90806-1714

Mailing address

2880 Atlantic Ave
Suite 110
Long Beach, CA 90806-1714
Phone (562) 424-4404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130911000876 CA Practitioner - Internal Medicine 5991949042 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4281 Katella Ave
Suite 111
Los Alamitos, CA 90720-3588
Phone (877) 486-1368

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Medical Associates Inc CurrentSince Apr 26, 2015 Accepting new patients
Corona Hospitalist Medical Group, Inc. Internal Medicine CurrentSince Jun 29, 2013 Accepting new patients
Temecula Valley Hospitalist Medical Group, Inc. Internal Medicine CurrentSince Mar 15, 2014 Accepting new patients
Hospitalist Group of Montebello Inc Past Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

31700 Temecula Pkwy
Temecula, CA 92592
Phone (951) 303-8939

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ampm Hospice IncSherman Oaks, CA, CCN B21712 Hospice 5% Or Greater Direct Ownership Interest (2%) May 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 7

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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1487810131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "SUITE 110",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-424-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "SUITE 110",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-424-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A12163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.