Active NPI
Jay K. Iinuma, MD
- Family Medicine Physician
- Los Angeles, CA
National Provider Identifier
1659442564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G77312
- Practice address
- 420 E 3Rd St Ste 904
Los Angeles, CA 90013-1647 - Phone
- (213) 947-3171
- Fax
- (213) 947-3173
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G077312 | CA | |
| Family Medicine Physician | 207Q00000X | G77312 | CA | Primary |
Addresses
Primary practice location
420 E 3Rd St Ste 904
Los Angeles, CA 90013-1647
Mailing address
420 E 3Rd St Ste 904
Los Angeles, CA 90013-1647
Phone (213) 947-3171
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of California, Geffen School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
420 E 3Rd St
Suite 904
Los Angeles, CA 90013-1647
Phone (213) 947-3171
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G077312 | CA | MD | Family Medicine Physician |
| G77312 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Memorial Medical Center | Past | Accepting new patients | |
| Usc Arcadia Hospital | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- jay.iinuma.1@16950.direct.athenahealth.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.
-
- Primary Care Clinic/Center
- Arcadia, CA
- NPI 1851709240
-
- Rehabilitation Hospital Unit
- Arcadia, CA
- NPI 1164410593
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1215927470
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Bethany Home Health Care
- Home Health Agency
- Alhambra, CA
- NPI 1801076625
-
- Home Health Agency
- Los Angeles, CA
- NPI 1003029703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659571200000",
"number": "1659442564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 E 3RD ST STE 904",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900131647",
"telephone_number": "213-947-3171",
"fax_number": "213-947-3173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 E 3RD ST STE 904",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900131647",
"telephone_number": "213-947-3171",
"fax_number": "213-947-3173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IINUMA",
"first_name": "JAY",
"middle_name": "K.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G077312",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G77312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.