Active NPI
Craig Jace, PA, LAC
- Medical Physician Assistant
- North Hollywood, CA
National Provider Identifier
1821184235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 12998
- Practice address
- 10843 Magnolia Blvd
North Hollywood, CA 91601 - Phone
- (818) 505-8610
- NPI assigned
- Oct 4, 2006
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 3835 | CA | |
| Medical Physician Assistant | 363AM0700X | 12998 | CA | Primary |
Addresses
Primary practice location
10843 Magnolia Blvd
North Hollywood, CA 91601
Mailing address
10843 Magnolia Blvd
North Hollywood, CA 91601
Phone (818) 505-8610
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170426001024 | CA | Order and Referring Only - Physician Assistant | 3274810429 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3835 | CA | MD | Acupuncturist |
| 12998 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275955200000",
"number": "1821184235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10843 MAGNOLIA BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "91601",
"telephone_number": "818-505-8610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10843 MAGNOLIA BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "91601",
"telephone_number": "818-505-8610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACE",
"first_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "PA, LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2010-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "3835",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "12998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.