Jacqueline Hayata

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

221 Westwood PLZ
Los Angeles, CA 90095-4103

Phone

(310) 825-4073

Fax

(310) 983-1172

NPI assigned

Apr 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Concepts Medical Group IncGroup PAC ID 6901793041, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jacqueline.hayata.p16@direct.healthcarepartners.nextgenshare.com

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.

• Modern Concepts Medical Group, Inc

  • Family Medicine Physician
  • Montebello, CA
  • NPI 1790738243
  Medicare reassignment Care Compare group
• Medison Corp

  • Urgent Care Clinic/Center
  • Torrance, CA
  • NPI 1760050587
  Medicare reassignment
• Modern Concepts Medical Group

  • Family Medicine Physician
  • Pasadena, CA
  • NPI 1194930420
  NPD (past)

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1861071102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 S OXFORD AVE APT 223",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900066306",
            "telephone_number": "310-622-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900954103",
            "telephone_number": "310-825-4073",
            "fax_number": "310-983-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYATA",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rie Hayashi, DDS
• Takae Hayashi, LMFT
• Yuichiro Hayashi, MD
• Akemi A Hayashibara, D.D.S.
• Eugene Yoshio Hayashibara, DDS
• Aleah Williams Hayden
• Christopher Miles Hayden
• Erin Michele Hayden, DPT
• Laurette Hayden, LMFT
• Lise Sloan Hayden

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.