Individual provider Active NPI

Jennifer Genova, MD

  • Pulmonary Disease Physician
  • Valencia, CA
National Provider Identifier
1588084586
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
148621 Issued in CA
Practice address
23845 McBean Pkwy
Valencia, CA 91355-2001
Phone
(661) 200-1122
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 148621 CA
Pulmonary Disease Physician 207RP1001X 148621 CA Primary

Addresses

Primary practice location

23845 McBean Pkwy
Valencia, CA 91355-2001

Mailing address

23845 McBean Pkwy
Valencia, CA 91355-2001
Phone (661) 200-1122

Other practice location 1

450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012
Phone (718) 270-8867

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
I20200918000553 CA Practitioner - Internal MedicinePractitioner - Pulmonary Disease 3375961659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SCCT Medical Group PCGroup PAC ID 4183978026, 12 clinicians

Practice addresses (Care Compare)

23845 McBean Pkwy
Valencia, CA 91355-2001
Phone 66120020001122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
148621CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC CurrentSince Aug 1, 2021 Accepting new patients
SCCT Medical Group, PC CurrentSince Oct 1, 2020 Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

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

23845 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-2000

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.

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1588084586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23845 MCBEAN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552001",
            "telephone_number": "661-200-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23845 MCBEAN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552001",
            "telephone_number": "661-200-1122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave # 1262",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-8867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENOVA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "148621",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "148621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.