Individual provider Active NPI

Jesil Joy Pazhayampallil

  • Pediatrics Physician
  • Santa Ana, CA
National Provider Identifier
1962744201
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A142986 Issued in CA
Practice address
2212 E 4TH St
Santa Ana, CA 92705-3870
Phone
(714) 571-7700
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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 A142986 CA Primary

Addresses

Primary practice location

2212 E 4TH St
Santa Ana, CA 92705-3870

Mailing address

2212 E 4TH St
Santa Ana, CA 92705-3870
Phone (714) 571-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240311000438 NY Practitioner - Pediatric Medicine 8325334329 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142986CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Jan 14, 2024 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Good Samaritan Hospital Medical Center Past Accepting new patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics PC Pediatrics Past Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

1 Hollow Ln
Ste 301
New Hyde Park, NY 11042
Phone (516) 207-7851

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 5

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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1962744201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053870",
            "telephone_number": "714-571-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053870",
            "telephone_number": "714-571-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZHAYAMPALLIL",
        "first_name": "JESIL",
        "middle_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A142986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.