Active NPI
Rome Jutabha, M.D.
- Gastroenterology Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G68613
- Practice address
- 1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312 - Phone
- (323) 442-5100
- NPI assigned
- Jul 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | G68613 | CA | |
| Gastroenterology Physician | 207RG0100X | G68613 | CA | Primary |
Addresses
Primary practice location
1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rome.jutabha@direct.usc.edu | Direct | USC CARE MEDICAL GROUP, INC |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11774 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| The Regents of the University of California | Current | Accepting new patients | |
| The Regents of the University of California | Gastroenterology | Current | Accepting new patients |
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| Keck Medical Center of Usc | Past | Accepting new patients | |
| UCLA Medical Group | Past | Accepting new patients | |
| Usc Verdugo Hills Hospital, LLC | Past | Accepting new patients | |
| Usc University Hospital, Inc. | Past | Accepting new patients | |
| The Regents of the University of California | Past | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
File 55737
Los Angeles, CA 90074
1520 San Pablo St
Ste 1000
Los Angeles, CA 90033
Phone (626) 457-5839
757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448
10833 Le Conte Ave
Los Angeles, CA 90095
Phone (310) 301-8932
200 Medical Plz
Ste 365A
Los Angeles, CA 90095
Phone (310) 206-0644
100 UCLA Medical Plz
Ste 310
Los Angeles, CA 90024
Phone (310) 267-7838
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500
200 UCLA Medical Plz
Ste 365C
Los Angeles, CA 90095
Phone (310) 206-7663
2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381
1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- rome.jutabha@direct.usc.edu
Organizations & group practices 9
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.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1235107566
Gastroenterology
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
-
- Ambulatory Surgical Clinic/Center
- Valencia, CA
- NPI 1689200305
-
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1417554528
-
- Transplant Surgery Physician
- Los Angeles, CA
- NPI 1902862170
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1043427248
-
- Psychiatric Hospital Unit
- Los Angeles, CA
- NPI 1790718500
-
- General Acute Care Hospital
- Glendale, CA
- NPI 1265875207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1790785434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "323-442-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SAN PABLO ST STE 1000",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335312",
"telephone_number": "323-442-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUTABHA",
"first_name": "ROME",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-22",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "G68613",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G68613",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rome.jutabha@direct.usc.edu",
"affiliation": "Y",
"affiliationName": "USC CARE MEDICAL GROUP, INC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1520 San Pablo St Ste 1000",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900335312",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.