Individual provider Active NPI

John Leon Ebrahim, M.D.

  • Hospitalist Physician
  • Santa Monica, CA
National Provider Identifier
1740629104
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
142685 Issued in CA
Practice address
1250 16TH St # C2304
Santa Monica, CA 90404-1249
Phone
(310) 319-4698
NPI assigned
Jun 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 142685 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1250 16TH St # C2304
Santa Monica, CA 90404-1249

Mailing address

1250 16TH St RM 2304
Santa Monica, CA 90404-1249
Phone (310) 319-4698

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160727001485 CA Practitioner - HospitalistPractitioner - Internal Medicine 1254624356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Perelman School of Med at the University of Pennsylvania, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1250 16TH St
Santa Monica, CA 90404-1249
Phone (424) 259-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Jun 30, 2016 Accepting new patients
The Regents of the University of California CurrentSince Jun 30, 2016 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

1250 16th St
Rm 2304
Santa Monica, CA 90404

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

1250 16th St
Ste A454
Santa Monica, CA 90404
Phone (310) 301-9469

1250 16th St
#C2304
Santa Monica, CA 90404

Interoperability endpoints

  • Direct secure messaging: jebrahim474732@direct.uclahealth.org

Organizations & group practices 3

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 2

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1740629104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 16TH ST RM 2304",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "310-319-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 16TH ST # C2304",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "310-319-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIM",
        "first_name": "JOHN",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "142685",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.