Individual provider Active NPI

Earl Moore-Jeffries, MD

  • Anesthesiology Physician
  • Pasadena, CA
National Provider Identifier
1528015583
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G68669 Issued in CA
Practice address
3135 Lombardy Rd
Pasadena, CA 91107-5574
Phone
(626) 585-0259
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G68669 CA Primary

Addresses

Primary practice location

3135 Lombardy Rd
Pasadena, CA 91107-5574

Mailing address

3135 Lombardy Rd
Pasadena, CA 91107
Phone (626) 585-0259

Other identifiers 1

IdentifierTypeStateIssuer
OOG686690MedicaidCA

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
I20041214000670 CA Practitioner - Anesthesiology 6305803065 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G68669CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Valley Medical Group Anesthesiology CurrentSince Feb 1, 2011 Accepting new patients
Uscan Anesthesiology Medical Group, Inc. Anesthesiology Past Accepting new patients
California Cancer Specialists Medical Group Inc Anesthesiology Past Accepting new patients

Locations

15503 Ventura Blvd
Ste 200
Encino, CA 91436
Phone (818) 788-7288

2131 W 3rd St
Los Angeles, CA 90057
Phone (213) 484-5525

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

333 S Arroyo Pkwy
Fl 3
Pasadena, CA 91105
Phone (626) 440-9161

Organizations & group practices 3

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1528015583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 LOMBARDY RD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-585-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 LOMBARDY RD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911075574",
            "telephone_number": "626-585-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-JEFFRIES",
        "first_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G68669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG686690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.