Individual provider Active NPI

Jheralyn G Martin, MSPA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1760814172
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22932 Issued in CA
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-1003
Phone
(310) 319-1234
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 22932 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-1003

Mailing address

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Other practice location 1

11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone (310) 478-3711

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140613001786 CA Practitioner - Physician Assistant 3072737014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 2062312291, 71 clinicians

Practice addresses (Care Compare)

100 Medical Plaza
Suite 170
Los Angeles, CA 90095-0001
Phone (310) 319-1234

1250 16TH St
Santa Monica, CA 90404-1249

Merit-based Incentive Payment System (MIPS)

Final score
87.27 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
68.99

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Apr 2, 2018 Accepting new patients
Regents of the University of California CurrentSince Apr 2, 2018 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Regents of the University of California Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

100 UCLA Medical Plz
Ste 755
Los Angeles, CA 90024
Phone (310) 206-2386

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

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

Interoperability endpoints

  • Direct secure messaging: jmartin610867@direct.uclahealth.org

Organizations & group practices 6

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1760814172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951003",
            "telephone_number": "310-319-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11301 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900731003",
            "country_code": "US",
            "telephone_number": "310-478-3711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JHERALYN",
        "middle_name": "G",
        "credential": "MSPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.