Individual provider Active NPI

Jonathan Nhut Quach, M.D

  • Addiction Medicine (Internal Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1811253909
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
A130657 Issued in CA
Practice address
200 UCLA Medical PLZ Ste 420
Los Angeles, CA 90095-3414
Phone
(310) 207-0117
Fax
(310) 207-0119
NPI assigned
Apr 3, 2012
Last updated
May 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A130657 CA
Hospitalist Physician 208M00000X A130657 CA
Addiction Medicine (Internal Medicine) Physician 207RA0401X A130657 CA Primary

Addresses

Primary practice location

200 UCLA Medical PLZ Ste 420
Los Angeles, CA 90095-3414

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1920 Colorado Ave
Santa Monica, CA 90404-3414
Phone (310) 319-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150618002944 CA Practitioner - Addiction MedicinePractitioner - Internal Medicine 0345551263 Reassigns benefits to 1 organization
I20211230000285 CA Practitioner - Internal Medicine 0345551263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001

100 Medical PLZ
Suite 310
Los Angeles, CA 90095-0001
Phone (310) 825-7922

200 Medical Plaza
Los Angeles, CA 90095-0001

200 Medical PLZ
Los Angeles, CA 90095-0001

200 UCLA Medical PLZ
Suite 165 34
Los Angeles, CA 90095-0001
Phone (310) 824-8403

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 267-9643

900 Weyburn Place
Suite 14 171
Los Angeles, CA 90095-0001
Phone (310) 825-8173

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130657CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clare Matrix CurrentSince Jun 4, 2023 Accepting new patients
Clare Matrix CurrentSince Nov 1, 2021 Accepting new patients
Clare Matrix Current Accepting new patients
UCLA Medical Group Internal Medicine Past Accepting new patients
Clare Matrix PastSince Nov 1, 2021 Accepting new patients
Clare Matrix Past Accepting new patients
UCLA Family Practice Past Accepting new patients

Locations

812 N Euclid Ave
Ontario, CA 91762
Phone (909) 395-0888

844 Pico Blvd
Santa Monica, CA 90405
Phone 3103146200 ext. 3576

2644 30th St
Ste 100
Santa Monica, CA 90405
Phone 31031462003426

Organizations & group practices 8

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 1

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1811253909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953414",
            "telephone_number": "310-207-0117",
            "fax_number": "310-207-0119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 Colorado Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904043414",
            "country_code": "US",
            "telephone_number": "310-319-4700",
            "fax_number": "310-453-5106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUACH",
        "first_name": "JONATHAN",
        "middle_name": "NHUT",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A130657",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A130657",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A130657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.