Individual provider Active NPI

Kayla Sivan Jagoda, MD

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1700317740
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A162382 Issued in CA
Practice address
1200 N State St
Clinic Tower, Suite A7D
Los Angeles, CA 90033-1029
Phone
(323) 226-2622
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 A162382 CA Primary

Addresses

Primary practice location

1200 N State St
Clinic Tower, Suite A7D
Los Angeles, CA 90033-1029

Mailing address

16 Empire Ave
Clinic Tower, Suite A7D
Saratoga Springs, NY 12866-6020
Phone (518) 915-5594

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210215001618 CA Practitioner - Emergency Medicine 5597178392 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A162382CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montclair Emergency Medical Associates Emergency Medicine CurrentSince May 1, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 3, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 3, 2022 Accepting new patients
Chino Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Jan 4, 2021 Accepting new patients
Orange County Emergency Medical Associates, Inc. Emergency Medicine CurrentSince May 27, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Midpacific Hospitalists LLC Past Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9400 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-6064

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

7901 Walker St
La Palma, CA 90623
Phone (562) 424-2900

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

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.

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1700317740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 EMPIRE AVE",
            "address_2": "CLINIC TOWER, SUITE A7D",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666020",
            "telephone_number": "518-915-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "CLINIC TOWER, SUITE A7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGODA",
        "first_name": "KAYLA",
        "middle_name": "SIVAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A162382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.