Individual provider Active NPI

Jonathan Brigham, MD

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1952730905
Registry record updated Nov 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A125956 Issued in CA
Practice address
4650 W Sunset Blvd
Pediatric Residency Office
Los Angeles, CA 90027-6062
Phone
(323) 361-2122
NPI assigned
Nov 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A125956 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Pediatric Residency Office
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd
Pediatric Residency Office
Los Angeles, CA 90027-6062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190710000415 CO Practitioner - Pediatric Medicine 5597984385 Reassigns benefits to 1 organization
I20260603001544 NV Practitioner - Pediatric Medicine 5597984385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Saint Louis University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 W Martin Luther King Blvd
Suite 1068
Chattanooga, TN 37402-2560

File
Suite 50978
Los Angeles, CA 90074-0001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A125956CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Colorado P C CurrentSince May 26, 2019 Accepting new patients
HCA Healthone LLC Past Accepting new patients

Locations

4722 N 24th St
Ste 150
Phoenix, AZ 85016
Phone (602) 256-4628

1719 E 19th Ave
Denver, CO 80218
Phone (303) 839-6000

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Interoperability endpoints

  • Direct secure messaging: jbrigham889148@ahs.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383955200000",
    "number": "1952730905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "PEDIATRIC RESIDENCY OFFICE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "PEDIATRIC RESIDENCY OFFICE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHAM",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-09",
        "last_updated": "2013-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A125956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.