Individual provider Active NPI

Reynaldo Limpin Makabali, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1598757577
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A51157 Issued in CA
Practice address
2426 W 8TH St Ste 104
Los Angeles, CA 90057-3840
Phone
(213) 389-9595
Fax
(213) 389-2556
NPI assigned
Aug 17, 2005
Last updated
Jan 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A51157 CA Primary
Pediatrics Physician 208000000X A51157 CA

Addresses

Primary practice location

2426 W 8TH St Ste 104
Los Angeles, CA 90057-3840

Mailing address

2426 W 8TH St Ste 104
Los Angeles, CA 90057-3840
Phone (213) 389-9595

Other identifiers 2

IdentifierTypeStateIssuer
00A511570MedicaidCA
CB208967OtherCAPTAN

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
I20060606000163 CA Practitioner - Family PracticePractitioner - Pediatric Medicine 7315958485 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Pediatric Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2426 W 8TH St
Suite 104
Los Angeles, CA 90057-3840
Phone (213) 389-9595

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A51157CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Los Remedios Medical Group Pediatrics Current Accepting new patients
Doctors on the Go Professional Group Corp Family Medicine CurrentSince Mar 2, 2020 Accepting new patients
Active Mobile Medical Group, Inc. Family Medicine PastSince Mar 6, 2022 Accepting new patients
Children's Hospital Los Angeles Mental Health Past Accepting new patients

Locations

2400 W 7th St
Ste 114
Los Angeles, CA 90057
Phone (213) 389-9898

3325 Wilshire Blvd
Ste 208
Los Angeles, CA 90010
Phone (213) 221-1272

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: reynaldo.makabali.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1598757577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 W 8TH ST STE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573840",
            "telephone_number": "213-389-9595",
            "fax_number": "213-389-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 W 8TH ST STE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573840",
            "telephone_number": "213-389-9595",
            "fax_number": "213-389-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKABALI",
        "first_name": "REYNALDO",
        "middle_name": "LIMPIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A51157",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A51157",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A511570",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CB208967",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.