Individual provider Active NPI

Anne Emiko Tsuchiyama, PA

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1962436568
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14461 Issued in CA
Practice address
200 Medical Plaza
#530
Los Angeles, CA 90095-0001
Phone
(310) 825-0631
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14461 CA Primary

Addresses

Primary practice location

200 Medical Plaza
#530
Los Angeles, CA 90095-0001

Mailing address

55737 File
Los Angeles, CA 90074-0001
Phone (310) 301-8708

Other identifiers 1

IdentifierTypeStateIssuer
00PA14461MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address atsuchiyama196710@oc.providencedirect.org

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
I20080528000351 CA Practitioner - Physician Assistant 1759451180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Glendale, CA 91202

520 N Prospect Ave
Redondo Beach, CA 90277-3033

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA14461CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince Mar 25, 2012 Accepting new patients
Providence Medical Institute CurrentSince Mar 25, 2012 Accepting new patients
Providence Medical Institute Past Accepting new patients
Providence Medical Institute Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

520 N Prospect Ave
Ste 200
Redondo Beach, CA 90277
Phone (310) 374-7655

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

520 N Prospect Ave
Ste 204
Redondo Beach, CA 90277
Phone (310) 372-4706

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: atsuchiyama196710@oc.providencedirect.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1962436568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55737 FILE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001",
            "telephone_number": "310-301-8708",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "#530",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUCHIYAMA",
        "first_name": "ANNE",
        "middle_name": "EMIKO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00PA14461",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atsuchiyama196710@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "520 N Prospect Ave Ste 103",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902773033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.