Individual provider Active NPI

Maria Elena Arredondo

  • Medical Physician Assistant
  • Lakewood, CA
National Provider Identifier
1942569553
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15147 Issued in CA
Practice address
5712 Coldbrook Ave
Lakewood, CA 90713-1442
Phone
(562) 762-6333
NPI assigned
May 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2012

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 PA15147 CA Primary

Addresses

Primary practice location

5712 Coldbrook Ave
Lakewood, CA 90713-1442

Mailing address

5712 Coldbrook Ave
Lakewood, CA 90713-1442
Phone (562) 762-6333

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
I20150204002571 CA Practitioner - Physician Assistant 2961727425 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15147CAMDOptometrist
PA15147CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Community Health Center, Inc CurrentSince Feb 4, 2021 Accepting new patients
Complete Care Community Health Center, Inc CurrentSince Feb 4, 2021 Accepting new patients
Vladimir Zeetser, DPM, Inc. PastSince Jan 1, 2022 Accepting new patients

Locations

2928 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 266-6700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: maria.arredondo.p1@direct.ccchcenter.nextgenshare.com

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, 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": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1942569553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5712 COLDBROOK AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131442",
            "telephone_number": "562-762-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5712 COLDBROOK AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131442",
            "telephone_number": "562-762-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "MARIA",
        "middle_name": "ELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.