Individual provider Active NPI

Edward Jay Rapetti, M.D.

  • Emergency Medicine Physician
  • Glendale, CA
National Provider Identifier
1689616369
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G42129 Issued in CA
Practice address
1420 S Central Ave
Glendale, CA 91204-2508
Phone
(818) 502-2344
Fax
(818) 502-4501
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G42129 CA Primary

Addresses

Primary practice location

1420 S Central Ave
Glendale, CA 91204-2508

Mailing address

PO Box 60039
Arcadia, CA 91066-6039
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
00G421290MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000523 CA Practitioner - Emergency Medicine 2769438548 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G42129CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Emergency Medical Associates, Inc Emergency Medicine CurrentSince Apr 1, 2005 Accepting new patients
Golden West Emergency Medical Associates, Inc Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients

Locations

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

Organizations & group practices 2

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1689616369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60039",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910666039",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042508",
            "telephone_number": "818-502-2344",
            "fax_number": "818-502-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPETTI",
        "first_name": "EDWARD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G42129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G421290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.