Michael Angel Jimenez, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MT189479 Issued in PA

Practice address

1064 Delaware Ave
Apt 2
Fountain Hill, PA 18015-2509

Phone

(310) 435-4140

NPI assigned

Aug 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

University of California, Geffen School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Institute of Trauma and Acute Care IncGroup PAC ID 6204101850, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Institute of Trauma and Acute Care Inc

  • Trauma Surgery Physician
  • Pomona, CA
  • NPI 1740711324
  Medicare reassignment Care Compare group NPD
• Bright Medical Associates, Inc.

  • Specialist
  • Whittier, CA
  • NPI 1578576880
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1407813660
  Care Compare affiliation

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187913600000",
    "number": "1679766331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 DELAWARE AVE APT 2",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180152509",
            "telephone_number": "310-435-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 DELAWARE AVE",
            "address_2": "APT 2",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180152509",
            "telephone_number": "310-435-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MICHAEL",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT189479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karyn J. Israel, M.D.
• Diana Marie Jaiyeola
• Jocelyn Jarick, PA-C
• Joyce Ann Jenkin
• Manuel J Jimenez-Serrano, MD
• John R. Hratko M.D.,P.C.
• Jeremy Kadish, D.O.
• Erin Kaminetsky
• Elizabeth Ann Kamp, PA-C
• Juanita Kaness, CRNP,RN

• Surgery Physician in Fountain Hill, PA
• Providers in Fountain Hill, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.

Verify at the official NPI Registry.