Individual provider Active NPI

Jesse David Sanders Jr., M.D.

  • Family Medicine Physician
  • Pacoima, CA
National Provider Identifier
1497756555
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G55931 Issued in CA
Practice address
12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone
(818) 896-0531
Fax
(818) 896-5850
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G55931 CA Primary

Addresses

Primary practice location

12756 Van Nuys Blvd
Pacoima, CA 91331-1626

Mailing address

1172 N Maclay Ave
San Fernando, CA 91340-1328
Phone (818) 898-1388

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
I20040417000538 CA Practitioner - Family Practice 0648265710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Stanford University School of Medicine, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Northeast Valley Health CorporationGroup PAC ID 3173517323, 77 clinicians

Practice addresses (Care Compare)

12451 Gain St
Pacoima, CA 91331-1642
Phone (818) 897-2193

12540 Pierce St
Pacoima, CA 91331-1701
Phone (818) 897-2193

12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531

12759 Van Nuys Blvd
Pacoima, CA 91331-1627
Phone (818) 485-8250

13356 Eldridge Ave
Sylmar, CA 91342-3200
Phone (818) 362-6182

14624 Sherman Way
FL 6
Van Nuys, CA 91405-2241
Phone (818) 988-6335

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086

23763 Valencia Blvd
Valencia, CA 91355-2105
Phone (661) 287-1551

7107 Remmet Ave
Canoga Park, CA 91303-2016
Phone (818) 340-3570

7843 Lankershim Blvd
North Hollywood, CA 91605-2523
Phone (818) 826-5555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G55931CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Valley Health Corporation Current Accepting new patients
Northeast Valley Health Corporation CurrentSince May 17, 2008 Accepting new patients
Northeast Valley Health Corporation CurrentSince May 17, 2008 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

12756 Van Nuys Blvd
Pacoima, CA 91331
Phone (818) 896-0531

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

6551 Van Nuys Blvd
Ste 201
Van Nuys, CA 91401
Phone (818) 765-8656

14624 Sherman Way
Fl 6
Van Nuys, CA 91405
Phone (818) 988-6335

8215 Van Nuys Blvd
Ste 306
Van Nuys, CA 91402
Phone (818) 376-0000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jesse.sanders.p1@direct.nevhc.nextgenshare.com

Organizations & group practices 4

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497756555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 N MACLAY AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913401328",
            "telephone_number": "818-898-1388",
            "fax_number": "818-365-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12756 VAN NUYS BLVD",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311626",
            "telephone_number": "818-896-0531",
            "fax_number": "818-896-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JESSE",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacoima, CA

Sources for this page

Verify at the official NPI Registry.