Individual provider Active NPI

Jerold Thomas Litoff, M.D.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Simi Valley, CA
National Provider Identifier
1710952544
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
A29343 Issued in CA
Practice address
2925 N. Sycamore Drive
Suite 202
Simi Valley, CA 93065-1208
Phone
(805) 527-3222
Fax
(805) 582-2651
NPI assigned
Feb 23, 2006
Last updated
Aug 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X A29343 CA Primary

Addresses

Primary practice location

2925 N. Sycamore Drive
Suite 202
Simi Valley, CA 93065-1208

Mailing address

2925 N. Sycamore Drive
Suite 202
Simi Valley, CA 93065-1208
Phone (805) 527-3222

Other identifiers 1

IdentifierTypeStateIssuer
00A293430MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29343CAMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1710952544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 N. SYCAMORE DRIVE",
            "address_2": "SUITE 202",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651208",
            "telephone_number": "805-527-3222",
            "fax_number": "805-582-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 N. SYCAMORE DRIVE",
            "address_2": "SUITE 202",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651208",
            "telephone_number": "805-527-3222",
            "fax_number": "805-582-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITOFF",
        "first_name": "JEROLD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "A29343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A293430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.