NPIMap

Organization Active NPI

Commons Clinic Medical Group, PC

  • Multi-Specialty Clinic/Center
  • Marina del Rey, CA
National Provider Identifier
1831856640
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
COMMONS CLINIC MEDICAL GROUP, PC
Practice address
13160 Mindanao Way Ste 300
Marina del Rey, CA 90292-6393
Phone
(310) 437-7925
NPI assigned
Nov 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Jean Ann Scarafia
Title
Vice President
Phone
(812) 629-3592

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207XX0005X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

13160 Mindanao Way Ste 300
Marina del Rey, CA 90292-6393

Mailing address

13160 Mindanao Way Ste 300
Marina del Rey, CA 90292-6393
Phone (812) 629-3592

Other practice location 1

2811 Wilshire Blvd Ste 850
Santa Monica, CA 90403-4812
Phone (310) 828-7757

Other practice location 2

2080 Century Park E Ste 1204
Los Angeles, CA 90067-2015
Phone (310) 595-1030

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220314001286 CA Part B Supplier - Clinic/Group Practice 6204221096 Receives reassigned benefits from 26 practitioners
Practice locations: Century City, CA; Torrance, CA; Santa Monica, CA; Marina del Rey, CA; Los Angeles, CA; Long Beach, CA; Lakewood, CA
O20250513000794 CA DME Supplier - Multi-Specialty - Physician 6204221096 Practice locations: Marina del Rey, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1831856640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926393",
            "telephone_number": "812-629-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926393",
            "telephone_number": "310-437-7925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2811 Wilshire Blvd Ste 850",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904034812",
            "country_code": "US",
            "telephone_number": "310-828-7757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2080 Century Park E Ste 1204",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900672015",
            "country_code": "US",
            "telephone_number": "310-595-1030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMONS CLINIC MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-29",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "SCARAFIA",
        "authorized_official_first_name": "JEAN ANN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "812-629-3592"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.