Individual provider Active NPI

Laurie Beth Juarez Morales, M.D.

  • Pediatrics Physician
  • Van Nuys, CA
National Provider Identifier
1538467477
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A121331 Issued in CA
Practice address
14426 Gilmore St
Van Nuys, CA 91401-1429
Phone
(818) 361-5437
Fax
(661) 213-9828
NPI assigned
Mar 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A121331 CA Primary

Addresses

Primary practice location

14426 Gilmore St
Van Nuys, CA 91401-1429

Mailing address

504 S Sierra Madre Blvd
Pasadena, CA 91107-5240
Phone (818) 361-5437

Other practice location 1

777 Truman St Ste 105
San Fernando, CA 91340-3383
Phone (818) 361-5437

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
I20140313001131 CA Practitioner - Pediatric Medicine 2466682422 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A121331CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Serra Community Medical Clinic, Inc. Pediatrics CurrentSince Jan 6, 2014 Accepting new patients
Serra Community Medical Clinic Inc CurrentSince Jan 6, 2014 Accepting new patients
Pediatric Affiliates Medical Group Inc Pediatrics Past Accepting new patients

Locations

9375 San Fernando Rd
Sun Valley, CA 91352
Phone (818) 504-4700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lbj192pcs@m1606.primeclinicalsystems.direct-ci.com

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": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1538467477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S SIERRA MADRE BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911075240",
            "telephone_number": "818-361-5437",
            "fax_number": "661-213-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14426 GILMORE ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011429",
            "telephone_number": "818-361-5437",
            "fax_number": "661-213-9828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Truman St Ste 105",
            "address_purpose": "LOCATION",
            "city": "San Fernando",
            "state": "CA",
            "postal_code": "913403383",
            "country_code": "US",
            "telephone_number": "818-361-5437",
            "fax_number": "661-213-9828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUAREZ MORALES",
        "first_name": "LAURIE BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A121331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.