Jay Edward Persselin, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

G44398 Issued in CA

Practice address

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Phone

(310) 268-3633

Fax

(310) 268-4250

NPI assigned

Jul 27, 2006

Last updated

Jul 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1952325268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-825-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "310-268-3633",
            "fax_number": "310-268-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSSELIN",
        "first_name": "JAY",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G44398",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "G44398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G443980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Personalized Nutrition Counseling LLC
• Personalized Physical Therapy & Wellness
• Lydia Mae Personius, MD
• Aubrey Lynne Persons
• Perspective Psychotherapy and Counseling Services LLC
• Roselou R Perun, NP
• Eric Perusquia
• Jacob Pesachov, MD
• Fred Pesante, RN
• Helen Pesante, RNP

• Rheumatology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Rheumatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.

Verify at the official NPI Registry.