Individual provider Active NPI

Johnathan M Hotta

  • Physician Assistant
  • West Hollywood, CA
National Provider Identifier
1902546922
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61399 Issued in CA
Practice address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone
(310) 423-8780
Fax
(310) 423-0424
NPI assigned
Mar 29, 2022
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA61399 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 423-8780

Other practice location 1

354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone (760) 633-6501

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
I20220805002776 CA Practitioner - Physician Assistant 6305228404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-5000

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61399CAMDGeneral Practice Dentistry
PA61399CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Mar 6, 2023 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Mar 6, 2023 Accepting new patients

Locations

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1902546922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "310-423-8780",
            "fax_number": "310-423-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-8780",
            "fax_number": "310-423-0424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Santa Fe Dr",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245142",
            "country_code": "US",
            "telephone_number": "760-633-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOTTA",
        "first_name": "JOHNATHAN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.