Jay Applebaum, M.D.,Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G54219 Issued in CA

Legal business name

JAY APPLEBAUM, M.D.,INC.

Practice address

17601 17TH St Ste 110
Tustin, CA 92780-1949

Phone

(714) 790-0005

Fax

(714) 699-2444

NPI assigned

May 15, 2007

Organization subpart

No

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

Authorized official

Name

Jay Applebaum, M.D.NPI 1740214618

Title

President

Phone

(714) 790-0005

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Jay Applebaum, M.D.

  • Procedural Dermatology Physician
  • Tustin, CA
  • NPI 1740214618
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1871709030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 110",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801949",
            "telephone_number": "714-790-0005",
            "fax_number": "714-699-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 110",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801949",
            "telephone_number": "714-790-0005",
            "fax_number": "714-699-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY APPLEBAUM, M.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "APPLEBAUM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-790-0005",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G54219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G542191",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0896423",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G54219",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nora M Jennings, MFT
• Jennifer Laura Jenrette, MSW

• Dermatology Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.