Individual provider Active NPI

Jennifer Kuo, NP

  • Family Nurse Practitioner
  • El Segundo, CA
National Provider Identifier
1811552805
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010349 Issued in CA
Practice address
898 N Pacific Coast Hwy Ste 600
El Segundo, CA 90245-2747
Phone
(310) 375-2134
NPI assigned
May 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010349 CA Primary

Addresses

Primary practice location

898 N Pacific Coast Hwy Ste 600
El Segundo, CA 90245-2747

Mailing address

2090 Westwood Blvd
Los Angeles, CA 90025-6329

Other names 1

  • Jennifer Ko Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001002720 CA Practitioner - Nurse Practitioner 8628497187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince Apr 1, 2023 Accepting new patients
Providence Facey Medical Foundation CurrentSince Jun 19, 2020 Accepting new patients
Exer Medical Corporation CurrentSince Jan 14, 2023 Accepting new patients
Providence Facey Medical Foundation CurrentSince Jun 19, 2020 Accepting new patients

Locations

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

26777 Agoura Rd
Ste B4
Calabasas, CA 91302
Phone (818) 880-2225

235 E 17th St
Costa Mesa, CA 92627
Phone (949) 688-2010

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

2381 Rosecrans Ave
Ste 115
El Segundo, CA 90245
Phone (213) 335-7355

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

5101 Lakewood Blvd
Lakewood, CA 90712
Phone (562) 800-3883

2090 Westwood Blvd
Los Angeles, CA 90025
Phone (213) 813-4070

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

725 S Pacific Coast Hwy
Redondo Beach, CA 90277
Phone (424) 296-3100

25548 The Old Rd
Ste U1
Stevenson Ranch, CA 91381
Phone (661) 556-9020

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

Interoperability endpoints

  • Direct secure messaging: jkuo789124@direct.memorialcare.org

Organizations & group practices 4

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": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1811552805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 WESTWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "898 N PACIFIC COAST HWY STE 600",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452747",
            "telephone_number": "310-375-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-05",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KO",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.