Individual provider Active NPI

Jordan Hertz Ylauan, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1750950952
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
300365 Issued in CA
Practice address
3617 Avalon Blvd
Los Angeles, CA 90011-5601
Phone
(213) 935-8566
NPI assigned
Jun 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 300365 CA Primary

Addresses

Primary practice location

3617 Avalon Blvd
Los Angeles, CA 90011-5601

Mailing address

801 Gramercy Dr Apt 602
Los Angeles, CA 90005-3407
Phone (818) 309-8555

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
300365CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jah Hand Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jordan.hertz.ylauan.1@10695.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1750950952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 GRAMERCY DR APT 602",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053407",
            "telephone_number": "818-309-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115601",
            "telephone_number": "213-935-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YLAUAN",
        "first_name": "JORDAN",
        "middle_name": "HERTZ",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.