Individual provider Active NPI

James Rae Cantu, M.D.

  • Family Medicine Physician
  • Venice, CA
National Provider Identifier
1780977512
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N9683 Issued in TX
Practice address
604 Rose Ave
Venice, CA 90291-2767
Phone
(310) 392-8636
NPI assigned
May 26, 2011
Last updated
May 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61661052 WA
Family Medicine Physician 207Q00000X N9683 TX Primary

Addresses

Primary practice location

604 Rose Ave
Venice, CA 90291-2767

Mailing address

7260 FM 1303
Floresville, TX 78114-6458
Phone (979) 739-3294

Other practice location 1

7424 Bridgeport Way W
Lakewood, WA 98499-8120
Phone (253) 240-2110

Other practice location 2

12 High St Ste 302
Lewiston, ME 04240-7690
Phone (207) 795-8385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, ME, CA, WA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20110929000508 TX Practitioner - Family Practice 6507037280 Reassigns benefits to 1 organization
I20230908002936 ME Practitioner - Family Practice 6507037280 Reassigns benefits to 1 organization
I20241115003084 CA Practitioner - Family Practice 6507037280 Reassigns benefits to 3 organizations
I20250422002149 WA Practitioner - Family Practice 6507037280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venice Family ClinicGroup PAC ID 2264339126, shared by 17 NPIs, 101 clinicians
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

604 Rose Ave
Venice, CA 90291-2767
Phone (310) 664-7901

7424 Bridgeport Way W
Lakewood, WA 98499-8120
Phone (253) 581-2111

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N9683TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic Current Accepting new patients
Central Maine Medical Center CurrentSince Jul 26, 2023 Accepting new patients
Venice Family Clinic CurrentSince Jan 20, 2026 Accepting new patients
Venice Family Clinic CurrentSince Jan 20, 2026 Accepting new patients
County of San Mateo CurrentSince Jul 28, 2024 Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic Current Accepting new patients
County of San Mateo CurrentSince Jul 28, 2024 Accepting new patients
Central Maine Medical Center CurrentSince Jul 26, 2023 Accepting new patients
Lawton Indian Hospital CurrentSince Jan 16, 2024 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
County of San Mateo CurrentSince Jul 28, 2024 Accepting new patients
Sea-Mar Community Health Center CurrentSince Mar 31, 2025 Accepting new patients
Sea Mar Community Health Centers CurrentSince Mar 31, 2025 Accepting new patients

Locations

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630

12 High St
Ste 302
Lewiston, ME 04240
Phone (207) 795-5730

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

1400 N Laventure Rd
Mount Vernon, WA 98273
Phone (360) 428-4075

7424 Bridgeport Way W
Tacoma, WA 98499
Phone (253) 581-2111

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1780977512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 FM 1303",
            "city": "FLORESVILLE",
            "state": "TX",
            "postal_code": "781146458",
            "telephone_number": "979-739-3294",
            "fax_number": "254-215-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 ROSE AVE",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912767",
            "telephone_number": "310-392-8636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7424 Bridgeport Way W",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984998120",
            "country_code": "US",
            "telephone_number": "253-240-2110",
            "fax_number": "253-240-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 High St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "042407690",
            "country_code": "US",
            "telephone_number": "207-795-8385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTU",
        "first_name": "JAMES",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-26",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61661052",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N9683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

Verify at the official NPI Registry.