Organization Active NPI

Jacques Courseault, MD, PC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Beverly Hills, CA
National Provider Identifier
1740152040
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
JACQUES COURSEAULT, MD, PC
Practice address
415 N Crescent Dr Ste 130
Beverly Hills, CA 90210-6816
Phone
(424) 378-3488
Fax
(800) 881-2038
NPI assigned
Sep 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Dr. Jacques Courseault, MD, CAQSMNPI 1205152162
Title
Ceo
Phone
(424) 378-3488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081S0010X Primary

Addresses

Primary practice location

415 N Crescent Dr Ste 130
Beverly Hills, CA 90210-6816

Mailing address

415 N Crescent Dr Ste 130
Beverly Hills, CA 90210-6816
Phone (424) 378-3488

Other names 1

  • The Fascia Institute and Treatment Center of LA, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

415 N Crescent Dr
Ste 130
Beverly Hills, CA 90210
Phone (310) 828-0101

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1740152040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CRESCENT DR STE 130",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902106816",
            "telephone_number": "424-378-3488",
            "fax_number": "800-881-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CRESCENT DR STE 130",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902106816",
            "telephone_number": "424-378-3488",
            "fax_number": "800-881-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUES COURSEAULT, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "COURSEAULT",
        "authorized_official_first_name": "JACQUES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-378-3488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, CAQSM"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Fascia Institute and Treatment Center of LA, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.