Active NPI
Tali Menachem, PA-C
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1700994449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 17510
- Practice address
- 11821 Goshen Ave
#4
Los Angeles, CA 90049-6344 - Phone
- (323) 369-6779
- NPI assigned
- Aug 25, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 17510 | CA | Primary |
Addresses
Primary practice location
11821 Goshen Ave
#4
Los Angeles, CA 90049-6344
Mailing address
11821 Goshen Ave
#4
Los Angeles, CA 90049-6344
Phone (323) 369-6779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Southern California Keck School of Medicine, 2004
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1250 S Beverly Glen Blvd
Los Angeles, CA 90024-5204
4800 T Rex Ave
Suite 200
Boca Raton, FL 33431-4479
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17510 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700994449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11821 GOSHEN AVE",
"address_2": "#4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900496344",
"telephone_number": "323-369-6779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11821 GOSHEN AVE",
"address_2": "#4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900496344",
"telephone_number": "323-369-6779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENACHEM",
"first_name": "TALI",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "17510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.