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JACQUELINE MEDINA SIMON
NPI 1083329841
Physician Assistant in Los Angeles, CA

Active since January 17, 2023PECOS Enrolled
1731 E 120TH ST, LOS ANGELES, CA 90059(323) 563-4800 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacqueline Medina Simon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE MEDINA SIMON (NPI 1083329841) is an individual physician assistant in Los Angeles, California and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083329841
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJACQUELINE MEDINA SIMON
Location Address1731 E 120TH STLos Angeles, CA 90059-3051
Mailing Address1731 E 120th StLos Angeles, CA 90059-3051 · (323) 563-4800
Phone(323) 563-4800
Sole ProprietorYes
Enumeration DateJanuary 17, 2023
NPPES CertifiedJanuary 17, 2023
✔ NPI 1083329841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1731 E 120TH ST, Los Angeles, CA 90059
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Medina Simon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90059 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON KAUANOE WILLIAMS MD
Psychiatry & Neurology (Psychiatry)
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 563-4800
CHRIS NOLASCO
Student in an Organized Health Care Education/Training Program
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 568-3347
SAMUEL KIM MD
Student in an Organized Health Care Education/Training Program
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 563-2480
KATIA CAMPOS
Student in an Organized Health Care Education/Training Program
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 563-4800
TIFFANY MOLINA TAN
Student in an Organized Health Care Education/Training Program
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 563-4800
JASMINE ALEXANDRIA HOLLOWAY
Physician Assistant
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 563-4800
SHARDAE BLANDIN
Physician Assistant
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 563-4800
BRIAN GIOVANNI MONTANO
Student in an Organized Health Care Education/Training Program
1731 E 120TH ST
LOS ANGELES, CA 90059
Los Angeles County (323) 563-4800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Simon's NPI number?

The NPI number for Jacqueline Simon is 1083329841. It was assigned to this individual provider in the NPPES registry on January 17, 2023.

Where is Jacqueline Simon located?

Jacqueline Simon practices at 1731 E 120th St, Los Angeles, CA 90059. The listed phone number is (323) 563-4800.

What is Jacqueline Simon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jacqueline Simon enrolled in Medicare?

Yes. Jacqueline Simon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacqueline Simon was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.