NPIMap

Individual provider Active NPI

Jennifer McNulty, MD

  • Maternal & Fetal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1629023296
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
GO78782 Issued in CA
Practice address
2840 Long Beach Blvd
Long Beach, CA 90806-1531
Phone
(562) 997-8510
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X GO78782 CA Primary

Addresses

Primary practice location

2840 Long Beach Blvd
Long Beach, CA 90806-1531

Mailing address

2840 Long Beach Blvd Ste 120
Long Beach, CA 90806-7506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110127000289 CA Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 4789863481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, Irvine, California College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magella Medical Group IncGroup PAC ID 7214827591, 23 clinicians

Practice addresses (Care Compare)

2888 Long Beach Blvd
Suite 400
Long Beach, CA 90806-1553
Phone 80024338397746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GO78782CAMDMaternal & Fetal Medicine Physician

Practice roles (6 of 7)

OrganizationSpecialtyStatusNew patients
Torrance Memorial Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorialcare Long Beach Medical CenterLong Beach, CA, CCN 050485 Hospital Corporate Director Jul 1, 2019
Memorialcare Miller Children'S & Women'S Hospital Long BeachLong Beach, CA, CCN 053309 Hospital Corporate Director Jul 1, 2019
Memorialcare Long Beach Medical CenterLong Beach, CA, CCN 05T485 Hospital Corporate Director Jul 1, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1629023296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 LONG BEACH BLVD STE 120",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908067506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 LONG BEACH BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061531",
            "telephone_number": "562-997-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "GO78782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.