Individual provider Active NPI

Rachel Caryn Edelman, PSYD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1497203103
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28436 Issued in CA
Practice address
300 UCLA Medical PLZ Ste 2200
Los Angeles, CA 90095-7602
Phone
(310) 825-9989
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 28436 CA
Clinical Psychologist 103TC0700X PSY28436 CA Primary

Addresses

Primary practice location

300 UCLA Medical PLZ Ste 2200
Los Angeles, CA 90095-7602

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

343 Saint Nicholas Ave Ste 1
New York, NY 10027-7602
Phone (424) 262-7618

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180119002406 CA Practitioner - Clinical Psychologist 2365701356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 0749180453, 148 clinicians

Practice addresses (Care Compare)

300 Medical PLZ
Suite 2200
Los Angeles, CA 90095-6968
Phone (310) 825-9989

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
76.01
Promoting interoperability
100
Improvement activities
40
Cost
56.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28436CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Clinical CurrentSince Dec 18, 2017 Accepting new patients

Locations

300 Medical Plz
Ste 2200
Los Angeles, CA 90095
Phone (310) 206-5133

300 UCLA Medical Plz
Ste 2200
Los Angeles, CA 90095
Phone (310) 267-6810

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1497203103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UCLA MEDICAL PLZ STE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957602",
            "telephone_number": "310-825-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 Saint Nicholas Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100277602",
            "country_code": "US",
            "telephone_number": "424-262-7618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDELMAN",
        "first_name": "RACHEL",
        "middle_name": "CARYN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2024-07-22",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "28436",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.