Active NPI
Jonas Fortin Obispo, NP
- Nurse Practitioner
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95015686
- Practice address
- 1250 16TH St # C2304
Santa Monica, CA 90404-1249 - Phone
- (310) 319-4698
- NPI assigned
- Mar 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95015686 | CA | Primary |
Addresses
Primary practice location
1250 16TH St # C2304
Santa Monica, CA 90404-1249
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95015686 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Wound Healing Medical Group Inc. | Current | Accepting new patients | |
| The Regents of the University of California | Current | Accepting new patients | |
| The Regents of the University of California | Current | Accepting new patients | |
| New Hope Podiatry Group Inc. | Past | Accepting new patients | |
| The Regents of the University of California | Past | Accepting new patients | |
| Memorial Medical Group Inc | Past | Accepting new patients |
Locations
100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146
24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252
File 55737
Los Angeles, CA 90074
5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200
892 Aerovista Pl
Ste 240
San Luis Obispo, CA 93401
Phone (805) 541-8252
2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381
1250 16th St
#C2304
Santa Monica, CA 90404
100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500
Interoperability endpoints
- jobispo739328@direct.uclahealth.org
Organizations & group practices 7
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.
-
dba UCLA Dept of Medicine
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1235107566
-
- Surgical Physician Assistant
- Alhambra, CA
- NPI 1235333972
-
- Internal Medicine Physician
- Rolling Hills Estates, CA
- NPI 1699165738
-
dba UCLA Dept of Medicine
- Ambulatory Surgical Clinic/Center
- Valencia, CA
- NPI 1689200305
-
- Foot & Ankle Surgery Podiatrist
- Alhambra, CA
- NPI 1447670955
-
dba Santa Monica UCLAMC and Orthopedic Hospital
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1982849105
-
- Durable Medical Equipment & Medical Supplies
- Phoenix, AZ
- NPI 1255523643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1699350074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631",
"telephone_number": "310-301-8707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 16TH ST # C2304",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904041249",
"telephone_number": "310-319-4698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBISPO",
"first_name": "JONAS",
"middle_name": "FORTIN",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-16",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95015686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
- Celeste Nicole O'Neill
- Nicole Oberfoell, MD
- Jessica Lyn Oberreuter, LMFT
- Emily Terfehr Oberstar
- Kristen Ego Obiakor, MD, MS
- Janet Ocampo, OTR/L
- Ocd Psychologists of Southern California Incorporated (OCD & Anxiety Program of Southern California)
- Ocean Community Care Services, Inc. (Ocean Community Care Center)
- Ocean Hearing Care
- Ocean Park Apothecary LLC (Ocean Park Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.