Active NPI
Jaime Moy, DO
- Pediatrics Physician
- Los Angeles, CA
National Provider Identifier
1891703989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A8734
- Practice address
- 2219 E 1St St
Los Angeles, CA 90033-3901 - Phone
- (323) 269-0421
- Fax
- (323) 780-9432
- NPI assigned
- Aug 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A8734 | CA | Primary |
Addresses
Primary practice location
2219 E 1St St
Los Angeles, CA 90033-3901
Mailing address
10418 Valley Blvd Ste B
El Monte, CA 91731-3600
Phone (626) 453-8466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX87340 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120927000290 | CA | Order and Referring Only - Pediatric Medicine | 4183660400 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320883200000",
"number": "1891703989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10418 VALLEY BLVD STE B",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917313600",
"telephone_number": "626-453-8466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2219 E 1ST ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900333901",
"telephone_number": "323-269-0421",
"fax_number": "323-780-9432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOY",
"first_name": "JAIME",
"name_prefix": "Ms.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2011-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A8734",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX87340",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.