Individual provider Active NPI

Jim Lui, PA

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1629774294
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
62485 Issued in CA
Practice address
954 N Vermont Ave
Los Angeles, CA 90029-3529
Phone
(562) 867-7999
NPI assigned
Feb 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 62485 CA Primary

Addresses

Primary practice location

954 N Vermont Ave
Los Angeles, CA 90029-3529

Mailing address

954 N Vermont Ave
Los Angeles, CA 90029-3529
Phone (562) 867-7999

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725001290 CA Practitioner - Physician Assistant 7719352384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
62485CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Jul 1, 2024 Accepting new patients
JWCH Institute, Inc. CurrentSince Jul 1, 2024 Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

954 N Vermont Ave
Los Angeles, CA 90029
Phone (323) 454-4850

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

Interoperability endpoints

  • Direct secure messaging: jim.luipa.p1@direct.jwch.nextgenshare.com

Organizations & group practices 3

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": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1629774294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293529",
            "telephone_number": "562-867-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293529",
            "telephone_number": "562-867-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUI",
        "first_name": "JIM",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.