Individual provider Active NPI

Grace Jean-Pierre, P.A.

  • Medical Physician Assistant
  • El Segundo, CA
National Provider Identifier
1891866828
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15266 Issued in CA
Practice address
2101 Rosecrans Ave # 3230
El Segundo, CA 90245-4749
Phone
(323) 628-8671
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA15266 CA Primary

Addresses

Primary practice location

2101 Rosecrans Ave # 3230
El Segundo, CA 90245-4749

Mailing address

1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3067
Phone (213) 481-2200

Other practice location 1

1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3067
Phone (213) 481-2200

Other identifiers 2

IdentifierTypeStateIssuer
PA15266OtherCASTATE LICENSE
WPA15266AMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15266CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Medical Center Inc. Past Accepting new patients
Ronald Seymour Weaver MD Inc. Past Accepting new patients
Ronald Seymour Weaver MD Inc Past Accepting new patients

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1891866828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153067",
            "telephone_number": "213-481-2200",
            "fax_number": "213-481-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ROSECRANS AVE # 3230",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454749",
            "telephone_number": "323-628-8671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 S Grand Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153067",
            "country_code": "US",
            "telephone_number": "213-481-2200",
            "fax_number": "213-481-7023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEAN-PIERRE",
        "first_name": "GRACE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA15266",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WPA15266A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.