Individual provider Active NPI

Jeffrey Ramirez, MD

  • Pediatrics Physician
  • San Pedro, CA
National Provider Identifier
1568090132
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A191155 Issued in CA
Practice address
425 S Pacific Ave
San Pedro, CA 90731-2625
Phone
(310) 547-0202
NPI assigned
Mar 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A191155 CA Primary

Addresses

Primary practice location

425 S Pacific Ave
San Pedro, CA 90731-2625

Mailing address

25829 Viana Ave Apt 8
Lomita, CA 90717-2814

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
I20240124004010 CA Practitioner - Pediatric Medicine 1355794538 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A191155CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Community Clinic Inc Pediatrics CurrentSince Nov 7, 2023 Accepting new patients
Harbor Community Clinic Inc. Current Accepting new patients

Locations

425 S Pacific Ave
San Pedro, CA 90731
Phone (310) 547-0202

593 W 6th St
San Pedro, CA 90731
Phone (310) 547-0202

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1568090132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25829 VIANA AVE APT 8",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S PACIFIC AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312625",
            "telephone_number": "310-547-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A191155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.