Individual provider Active NPI

Jessica Farmer

  • Family Medicine Physician
  • Harbor City, CA
National Provider Identifier
1790246460
Registry record updated Nov 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2074 Issued in CA
Practice address
1403 Lomita Blvd Ste 200
Harbor City, CA 90710-2086
Phone
(310) 602-2600
NPI assigned
Mar 26, 2019
Last updated
Nov 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2074 CA Primary

Addresses

Primary practice location

1403 Lomita Blvd Ste 200
Harbor City, CA 90710-2086

Mailing address

1403 Lomita Blvd Ste 200
Harbor City, CA 90710-2086
Phone (310) 602-2600

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
I20240724002733 CA Practitioner - Family Practice 9638615859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay AIDS Center Medical Group IncGroup PAC ID 2668497843, 6 clinicians

Practice addresses (Care Compare)

3100 Summit St
Oakland, CA 94609-3412
Phone (510) 869-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2074CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay AIDS Center Medical Group Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

3100 Summit St
Fl 2
Oakland, CA 94609
Phone (510) 869-8400

Interoperability endpoints

  • Direct secure messaging: jfarmer686665@hisp.ehr.sutterhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606521600000",
    "number": "1790246460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD STE 200",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102086",
            "telephone_number": "310-602-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD STE 200",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102086",
            "telephone_number": "310-602-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2020-11-28",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "2074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

Verify at the official NPI Registry.