Individual provider Active NPI

Jose M Elacion, M.D.

  • Family Medicine Physician
  • Panorama City, CA
National Provider Identifier
1497823405
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C50675 Issued in CA
Practice address
14427 Chase St
Panorama City, CA 91402-3020
Phone
(818) 830-7751
Fax
(818) 891-7892
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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 C50675 CA Primary

Addresses

Primary practice location

14427 Chase St
Panorama City, CA 91402-3020

Mailing address

3810 Wilshire Blvd
Apt 503
Los Angeles, CA 90010-3204
Phone (562) 506-3001

Other identifiers 1

IdentifierTypeStateIssuer
00C506750MedicaidCA

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
I20250117003151 CA Order and Referring Only - Family PracticePractitioner - Family Practice 1052220480

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C50675CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Hospice Inc Family Medicine PastSince Mar 12, 2001 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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
Noble Heart Hospice and Palliative CareTorrance, CA, CCN A01634 Hospice W-2 Managing Employee (100%) Feb 3, 2020

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 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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1497823405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 WILSHIRE BLVD",
            "address_2": "APT 503",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103204",
            "telephone_number": "562-506-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14427 CHASE ST",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023020",
            "telephone_number": "818-830-7751",
            "fax_number": "818-891-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELACION",
        "first_name": "JOSE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C50675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C506750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.