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DR. ALFRED JOHN PENNISI M.D.
NPI 1356444855
Pediatrics in Los Angeles, CA

Active since September 07, 2006PECOS Enrolled
10833 LE CONTE AVE, 12-441 MDCC, LOS ANGELES, CA 90095(310) 825-9346(310) 206-4855 Get Directions Write a Review

NPPES record last updated: April 9, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Alfred John Pennisi M.d. NPPES

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

DR. ALFRED JOHN PENNISI M.D. (NPI 1356444855) is an individual pediatrics provider in Los Angeles, California, licensed in California (G21570) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356444855
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. ALFRED JOHN PENNISICredential: M.D.
Location Address10833 LE CONTE AVE, 12-441 MDCCLos Angeles, CA 90095-3075
Mailing Address10833 Le Conte Ave, 12-441 MdccLos Angeles, CA 90095-3075 · (310) 825-9346 · Fax (310) 206-4855
Phone(310) 825-9346
Fax(310) 206-4855
Sole ProprietorNo
Enumeration DateSeptember 7, 2006
Last NPPES UpdateApril 9, 2012
✔ NPI 1356444855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · G21570
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
10833 LE CONTE AVE, Los Angeles, CA 90095
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Other Identifiers 5

Medicare ID-Type UnspecifiedW11810CA · Group
Medicare ID-Type UnspecifiedWG21570ACA
Medicaid00G215700CA
MedicaidGR0053510CA
Medicare UPINB50984CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Alfred John Pennisi M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Alfred Pennisi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gracelight Community Health
8.6 mi
Federally Qualified Health Center (FQHC)
5000 W SUNSET BLVD STE 400
Los Angeles, CA 90027
  • Reassigned Medicare billing, California enrollment
  • 75 clinicians in this Medicare group
NPI 1639241888 (323) 953-7170

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90095 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
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
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.

DR. JENNIFER A FULCHER M.D., PH.D.
Internal Medicine (Infectious Disease)
10833 LE CONTE AVE, CHS 37-121
LOS ANGELES, CA 90095
Los Angeles County (310) 825-7225
LEE HAROLD HILBORNE MD
Pathology (Anatomic Pathology & Clinical Pathology)
10833 LE CONTE AVE, STE B-186 CHS
LOS ANGELES, CA 90095
Los Angeles County (310) 794-8285
PETER TONTONOZ MD
Pathology (Anatomic Pathology)
10833 LE CONTE AVE, STE B-186 CHS
LOS ANGELES, CA 90095
Los Angeles County (310) 794-8285
HSIN Y LEE MD
Radiology (Diagnostic Radiology)
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-4721
COLIN J. WELLS MD
Radiology (Diagnostic Radiology)
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 301-6800
RODNEY L TEICHNER MD
Anesthesiology
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-9111
DR. LLOYD EDWARD GREASER III M.D.
Radiology (Diagnostic Radiology)
10833 LE CONTE AVE, DEPARTMENT OF RADIOLOGY
LOS ANGELES, CA 90095
Los Angeles County (310) 825-4321
BRANDON KEN ITAGAKI M.D.
Internal Medicine
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-8307

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 Alfred Pennisi's NPI number?

The NPI number for Alfred Pennisi is 1356444855. It was assigned to this individual provider in the NPPES registry on September 7, 2006.

Where is Alfred Pennisi located?

Alfred Pennisi practices at 10833 Le Conte Ave 12-441 Mdcc, Los Angeles, CA 90095. The listed phone number is (310) 825-9346.

What is Alfred Pennisi's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Alfred Pennisi enrolled in Medicare?

Yes. Alfred Pennisi is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Alfred Pennisi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alfred Pennisi reassigns Medicare benefits to Gracelight Community Health (Los Angeles, CA). The 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 Alfred Pennisi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Alfred Pennisi was last updated on April 9, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.