Individual provider Active NPI

Juan Carlos Duran, MD

  • Epilepsy Physician
  • Los Angeles, CA
National Provider Identifier
1760913867
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
187347 Issued in CA
Practice address
1505 N Edgemont St FL 5
Los Angeles, CA 90027-5209
Phone
(800) 464-4000
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Epilepsy Physician 2084E0001X 187347 CA Primary

Addresses

Primary practice location

1505 N Edgemont St FL 5
Los Angeles, CA 90027-5209

Mailing address

3959 Broadway
New York, NY 10032-1559
Phone (212) 805-8504

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20231108002815 CA Practitioner - Neurology 5597112839 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
187347CAMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 27, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 27, 2023 Accepting new patients

Locations

1505 N Edgemont St
Fl 5
Los Angeles, CA 90027
Phone (202) 276-2185

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

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.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1760913867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-805-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 N EDGEMONT ST FL 5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275209",
            "telephone_number": "800-464-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2023-10-27",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "CA",
            "license": "187347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.