Individual provider Active NPI

Jay D. Pruetz, M.D.

  • Pediatric Cardiology Physician
  • Los Angeles, CA
National Provider Identifier
1790771053
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A81000 Issued in CA
Practice address
127 S San Vicente Blvd Ste A3600
Los Angeles, CA 90048-3311
Phone
(310) 423-1153
Fax
(310) 423-6795
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A81000 CA
Pediatric Cardiology Physician 2080P0202X A81000 CA Primary

Addresses

Primary practice location

127 S San Vicente Blvd Ste A3600
Los Angeles, CA 90048-3311

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

5411 Etiwanda Ave Ste 250
Tarzana, CA 91356-6158
Phone (310) 423-1153

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
I20041022001137 CA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 7618938556 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of California, Geffen School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-3277

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Oct 1, 2025 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Sep 14, 2009 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Mar 1, 2024 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Mar 1, 2024 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Oct 1, 2025 Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Northeast Valley Health Corporation Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Northeast Valley Health Corporation Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

127 S San Vicente Blvd
Ste A3600
Los Angeles, CA 90048
Phone (310) 423-2726

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

5411 Etiwanda Ave
Ste 200
Tarzana, CA 91356
Phone (310) 423-2129

5411 Etiwanda Ave
Ste 250
Tarzana, CA 91356
Phone (310) 423-1153

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: jpruetz419113@direct.cshs.org

Organizations & group practices 11

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1790771053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S SAN VICENTE BLVD STE A3600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483311",
            "telephone_number": "310-423-1153",
            "fax_number": "310-423-6795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5411 Etiwanda Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913566158",
            "country_code": "US",
            "telephone_number": "310-423-1153",
            "fax_number": "310-423-6795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUETZ",
        "first_name": "JAY",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A81000",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A81000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.