Individual provider Active NPI

Suma Jacob, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1932269396
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C199229 Issued in CA
Practice address
760 Westwood PLZ # 48-240a
Los Angeles, CA 90095-1450
Phone
(310) 825-9989
Fax
(310) 267-1908
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C199229 CA Primary
Child & Adolescent Psychiatry Physician 2084P0804X C199229 CA

Addresses

Primary practice location

760 Westwood PLZ # 48-240a
Los Angeles, CA 90095-1450

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 2

IdentifierTypeStateIssuer
1932269396MedicaidMN
260003800OtherMNMEDICARE PTAN

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
I20250116002446 CA Practitioner - Psychiatry 5991714446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Chicago, Pritzker School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UC RegentsGroup PAC ID 0749180453, 148 clinicians

Practice addresses (Care Compare)

300 Medical PLZ
Suite 2200
Los Angeles, CA 90095-6968
Phone (310) 825-9989

757 Westwood PLZ
Los Angeles, CA 90095-0001
Phone (310) 825-9111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C199229CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Psychiatry CurrentSince Feb 1, 2025 Accepting new patients
University of Minnesota Physicians Past Accepting new patients
Oak Forest Psychological Service Psychiatry Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

760 Westwood Plz
#48240A
Los Angeles, CA 90095

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

760 Westwood Plz
Ste 48240A
Los Angeles, CA 90095

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

Organizations & group practices 4

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1932269396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ # 48-240A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951450",
            "telephone_number": "310-825-9989",
            "fax_number": "310-267-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SUMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C199229",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "C199229",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932269396",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "260003800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.