Individual provider Active NPI

Thaddeus Michael Juarez, M.D.

  • Psychiatry Physician
  • Beverly Hills, CA
National Provider Identifier
1982829248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A83085 Issued in CA
Practice address
9777 Wilshire Blvd
#911
Beverly Hills, CA 90212-1910
Phone
(310) 850-6588
Fax
(310) 279-1190
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A83085 CA Primary

Addresses

Primary practice location

9777 Wilshire Blvd
#911
Beverly Hills, CA 90212-1910

Mailing address

9777 Wilshire Blvd
#911
Beverly Hills, CA 90212-1910
Phone (310) 850-6588

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121011000910 CA Practitioner - Psychiatry 7315196011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Washington School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

1020 S Arroyo Pkwy
Pasadena, CA 91105-3911
Phone (626) 403-2794

679 S New Hampshire Ave
Suite 400
Los Angeles, CA 90005-1355
Phone (213) 639-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83085CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince Jan 15, 2022 Accepting new patients
Pacific Clinics CurrentSince Jan 15, 2022 Accepting new patients
Pacific Clinics Current Accepting new patients

Locations

800 S Santa Anita Ave
Arcadia, CA 91006
Phone (626) 254-5043

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

Organizations & group practices 3

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982829248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 WILSHIRE BLVD",
            "address_2": "#911",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121910",
            "telephone_number": "310-850-6588",
            "fax_number": "310-279-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 WILSHIRE BLVD",
            "address_2": "#911",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121910",
            "telephone_number": "310-850-6588",
            "fax_number": "310-279-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "THADDEUS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A83085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.