NPIMap

Individual provider Active NPI

Victor Felipe Jimenez, P.A.C.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1720113079
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA19072 Issued in CA
Practice address
745 S Alvarado St
Los Angeles, CA 90057-4021
Phone
(213) 252-2225
Fax
(213) 252-2244
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA19072 CA Primary

Addresses

Primary practice location

745 S Alvarado St
Los Angeles, CA 90057-4021

Mailing address

745 S Alvarado St
Los Angeles, CA 90057-4021
Phone (213) 252-2225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000478 CA Practitioner - Physician Assistant 4082764121 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Hematology Oncology Medical Group IncGroup PAC ID 3779840459, 8 clinicians
Raj Prasad MD, Inc.Group PAC ID 7810067378, 3 clinicians

Practice addresses (Care Compare)

6221 Wilshire Blvd
Suite 504
Los Angeles, CA 90048-5223
Phone (323) 965-9995

8711 Venice Blvd
Los Angeles, CA 90034-3216
Phone (310) 237-0023

Hospital & facility affiliations

  • L a Downtown Medical Center Hospital, Los Angeles, CA, CCN 050763
  • Los Angeles Community Hospital Hospital, Los Angeles, CA, CCN 050663
  • Southern California Hospital at Hollywood Hospital, Hollywood, CA, CCN 050135
  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104
  • Memorial Hospital of Gardena Hospital, Gardena, CA, CCN 050468

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
93.72 of 100Reported as group
Quality
100
Improvement activities
40
Cost
45.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19072CAMDFamily Medicine Physician
19072CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
R Srinivasan MD Inc Family Medicine Past Accepting new patients
Unicare Community Health Center, Inc. Past Accepting new patients

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1720113079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574021",
            "telephone_number": "213-252-2225",
            "fax_number": "213-252-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574021",
            "telephone_number": "213-252-2225",
            "fax_number": "213-252-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "VICTOR",
        "middle_name": "FELIPE",
        "name_prefix": "Mr.",
        "credential": "P.A.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA19072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.