Individual provider Active NPI

Janae D Floyd, PA

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1699071571
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21315 Issued in CA
Practice address
808 W 58TH St
Los Angeles, CA 90037-3632
Phone
(323) 514-1600
NPI assigned
Feb 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA21315 CA
Physician Assistant 363A00000X PA21315 CA Primary

Addresses

Primary practice location

808 W 58TH St
Los Angeles, CA 90037-3632

Mailing address

9014 S 4TH Ave
Inglewood, CA 90305-2816
Phone (323) 253-0288

Other identifiers 1

IdentifierTypeStateIssuer
PA21315OtherCAPA LIC

Other names 1

  • Janae Vickers Former name

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
I20130620000550 CA Practitioner - Physician Assistant 1355580416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Roads Foundation, IncGroup PAC ID 2961722558, 57 clinicians

Practice addresses (Care Compare)

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA21315CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Apr 24, 2013 Accepting new patients
The Roads Foundation, Inc. CurrentSince Aug 1, 2019 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

121 S Long Beach Blvd
Compton, CA 90221
Phone (310) 627-5850

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

4800 E Los Coyotes Diagonal
Long Beach, CA 90815
Phone (310) 627-5850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD
  • Direct secure messaging: janae.floyd@rccc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1699071571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9014 S 4TH AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903052816",
            "telephone_number": "323-253-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "323-514-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "JANAE",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21315",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LIC",
            "identifier": "PA21315",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANAE",
            "last_name": "VICKERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.