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JED PADRE MD INC
NPI 1225643448
Family Medicine in Carson, CA

Active since September 14, 2020CLIA 05D0887841 · Waiver
282 E SEPULVEDA BLVD, CARSON, CA 90745(310) 518-6861(310) 835-1366 Get Directions Write a Review

NPPES record last updated: September 14, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jed Padre Md Inc NPPES

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

JED PADRE MD INC (NPI 1225643448) is a healthcare organization registered as a family medicine in Carson, California and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through June 19, 2028 and lists Jed Padre, Owner, as its authorized official.

NPPES Registry Identity

NPI1225643448
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJED PADRE MD INC
Location Address282 E SEPULVEDA BLVDCarson, CA 90745-6323
Mailing Address282 E Sepulveda BlvdCarson, CA 90745-6323 · (310) 518-6861 · Fax (310) 835-1366
Phone(310) 518-6861
Fax(310) 835-1366
Organization SubpartNo
Authorized OfficialJed PadreOwner · (310) 518-6861
Enumeration DateSeptember 14, 2020
NPPES CertifiedSeptember 14, 2020
✔ NPI 1225643448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
282 E SEPULVEDA BLVD, Carson, CA 90745
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jed Padre Md Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Jed Padre MD Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jed Padre, MD
Family Practice
NPI 1285169110
282 E SEPULVEDA BLVD
Carson, CA 90745
(310) 518-6861
✔ PECOS✔ Accepts MedicareSame address
Diane Padre-Gozun
Family Practice
NPI 1457858714
282 E SEPULVEDA BLVD
Carson, CA 90745
(310) 518-6861
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0887841

Jed Padre MD Inc · Carson, CA
Active · expires Jun 19, 2028
CLIA Number05D0887841
Laboratory TypePhysician Office
Certificate Effective DateJune 20, 2026
Certificate Expiration DateJune 19, 2028
Laboratory DirectorJed Padre
Laboratory Phone(310) 518-6861
Laboratory LocationJed Padre MD Inc282 E Sepulveda Blvd, Carson, CA 90745
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Jed Padre MD Inc's NPI number?

The NPI number for Jed Padre MD Inc is 1225643448. It was assigned to this organization in the NPPES registry on September 14, 2020.

Where is Jed Padre MD Inc located?

Jed Padre MD Inc is located at 282 E Sepulveda Blvd, Carson, CA 90745. The listed phone number is (310) 518-6861.

What is Jed Padre MD Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jed Padre MD Inc enrolled in Medicare?

Yes. Jed Padre MD Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jed Padre MD Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Jed Padre MD Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Jed Padre MD Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0887841) is associated with this NPI, valid through June 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jed Padre MD Inc was last updated on September 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.