Individual provider Active NPI

Paayal Bhakta

  • Pediatrics Physician
  • Commerce, CA
National Provider Identifier
1750701926
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A149562 Issued in CA
Practice address
5650 Jillson St
Commerce, CA 90040-1482
Phone
(323) 201-4516
NPI assigned
Apr 25, 2014
Last updated
Jan 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A149562 CA Primary

Addresses

Primary practice location

5650 Jillson St
Commerce, CA 90040-1482

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191230001282 CA Practitioner - Pediatric Medicine 5698109627 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149562CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Nov 18, 2019 Accepting new patients
JWCH Institute Inc CurrentSince Nov 18, 2019 Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

954 N Vermont Ave
Los Angeles, CA 90029
Phone (323) 454-4850

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: paayal.bhaktamd.p1@direct.jwch.nextgenshare.com

Organizations & group practices 2

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": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1750701926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "PAAYAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A149562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, CA

Sources for this page

Verify at the official NPI Registry.