Individual provider Active NPI

Jeison Danilo Recinos, M.D.

  • Internal Medicine Physician
  • Sylmar, CA
National Provider Identifier
1871948760
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A156178 Issued in CA
Practice address
14445 Olive View Dr
Sylmar, CA 91342-1437
Phone
(818) 364-3205
NPI assigned
Apr 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A156178 CA Primary

Addresses

Primary practice location

14445 Olive View Dr
Sylmar, CA 91342-1437

Mailing address

11342 Covello St
Sun Valley, CA 91352-4711
Phone (818) 203-4266

Other names 1

  • Dr. Jeison Danilo Recinos Alvarado Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715001944 CA Practitioner - Internal Medicine 3577898436 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A156178CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Jun 1, 2019 Accepting new patients
County of Los Angeles CurrentSince Jun 1, 2019 Accepting new patients

Locations

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

14445 Olive View Dr
Rm 28182
Sylmar, CA 91342

Organizations & group practices 3

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1871948760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11342 COVELLO ST",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913524711",
            "telephone_number": "818-203-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-364-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECINOS",
        "first_name": "JEISON",
        "middle_name": "DANILO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A156178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEISON",
            "last_name": "RECINOS ALVARADO",
            "middle_name": "DANILO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.