Active NPI
Jhaimy C Fernandez
- Family Medicine Physician
- Marina del Rey, CA
National Provider Identifier
1508448069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A184788
- Practice address
- 4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424 - Phone
- (310) 827-3700
- NPI assigned
- Apr 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A184788 | CA | Primary |
Addresses
Primary practice location
4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
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
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Vermont College of Medicine, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5767 W Century Blvd
Los Angeles, CA 90045-5631
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- jhaimy.fernandez.1@17371.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1508448069",
"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": "4560 ADMIRALTY WAY STE 100",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902925424",
"telephone_number": "310-827-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "JHAIMY",
"middle_name": "C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-24",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A184788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.