Individual provider Active NPI

Jessica A Marine

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1891556353
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
607 S Atlantic Blvd
Los Angeles, CA 90022-3211
Phone
(323) 268-9191
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

607 S Atlantic Blvd
Los Angeles, CA 90022-3211

Mailing address

607 S Atlantic Blvd
Los Angeles, CA 90022-3211
Phone (323) 268-9191

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241110000016 CA Practitioner - Physician Assistant 3577097815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Via Care Community Health CenterGroup PAC ID 1052550365, 10 clinicians

Practice addresses (Care Compare)

280 S Atlantic Blvd
Los Angeles, CA 90022-1733
Phone (323) 268-9191

284 S Atlantic Blvd
Los Angeles, CA 90022-1733
Phone (323) 268-9191

4755 E Cesar E Chavez Ave
Los Angeles, CA 90022-1209
Phone (323) 268-9191

501 S Atlantic Blvd
East Los Angeles, CA 90022-2621

501 S Woods Ave
Los Angeles, CA 90022-1976
Phone (323) 268-9191

5015 Whittier Blvd
Los Angeles, CA 90022-3116
Phone (323) 268-9191

5017 Whittier Blvd
East Los Angeles, CA 90022-3116
Phone (323) 268-9191

507 S Atlantic Blvd
Los Angeles, CA 90022-2621
Phone (323) 268-9191

607 S Atlantic Blvd
Los Angeles, CA 90022-3211
Phone (323) 268-9191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Via Care Community Health Center CurrentSince Sep 23, 2024 Accepting new patients
Via Care Community Health Center CurrentSince Sep 23, 2024 Accepting new patients

Locations

501 S Atlantic Blvd
Los Angeles, CA 90022
Phone (323) 268-5442

607 S Atlantic Blvd
Los Angeles, CA 90022
Phone (213) 327-7828

507 S Atlantic Blvd
Los Angeles, CA 90022
Phone 32326891911067

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": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1891556353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223211",
            "telephone_number": "323-268-9191",
            "fax_number": "323-268-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223211",
            "telephone_number": "323-268-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINE",
        "first_name": "JESSICA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.