Individual provider Active NPI

Jacqueline E Yaris, M.D.

  • Internal Medicine Physician
  • Beverly Hills, CA
National Provider Identifier
1558375485
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G81181 Issued in CA
Practice address
9725 Wilshire Blvd
Beverly Hills, CA 90212-2002
Phone
(323) 305-7150
Fax
(323) 305-7149
NPI assigned
Jul 28, 2006
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G81181 CA Primary

Addresses

Primary practice location

9725 Wilshire Blvd
Beverly Hills, CA 90212-2002

Mailing address

9725 Wilshire Blvd
Beverly Hills, CA 90212-2002
Phone (323) 305-7150

Other practice location 1

632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254

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
I20101025000669 CA Practitioner - Family PracticePractitioner - Internal Medicine 9032302864 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 N See Vee LN
Bishop, CA 93514-8130
Phone (760) 873-8464

PO Box
Suite 660
Mammoth Lakes, CA 93546-0660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G81181CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Toiyabe Indian Health Project, Inc CurrentSince Aug 20, 2025 Accepting new patients
Providence Saint Johns Medical Foundation Internal Medicine CurrentSince Mar 1, 2019 Accepting new patients
Toiyabe Indian Health Project, Inc CurrentSince Aug 20, 2025 Accepting new patients
Southern Mono Health Care District CurrentSince Jan 1, 2021 Accepting new patients

Locations

9725 Wilshire Blvd
Beverly Hills, CA 90212
Phone (310) 500-2040

250 N See Vee Ln
Bishop, CA 93514
Phone (760) 873-8461

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

Interoperability endpoints

  • Direct secure messaging: jacqueline.yaris.p1@direct.toiyabe.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1558375485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 WILSHIRE BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122002",
            "telephone_number": "323-305-7150",
            "fax_number": "323-305-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 WILSHIRE BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122002",
            "telephone_number": "323-305-7150",
            "fax_number": "323-305-7149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Broadway Ph",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YARIS",
        "first_name": "JACQUELINE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G81181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.