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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JAMIE PHAN PA-C
NPI 1619600194
Physician Assistant in Marina Del Rey, CA

Active since July 02, 2022PECOS Enrolled
4551 GLENCOE AVE STE 145, MARINA DEL REY, CA 90292(310) 405-0595 Get Directions Write a Review

NPPES record last updated: September 1, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 1, 2026, Aug 14, 2023, Jul 3, 2023 (3 updates tracked since 2023).

About Jamie Phan Pa-c NPPES

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

JAMIE PHAN PA-C (NPI 1619600194) is an individual physician assistant in Marina Del Rey, California, licensed in California (62966) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Monterey Park.

NPPES Registry Identity

NPI1619600194
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJAMIE PHANCredential: PA-C
Location Address4551 GLENCOE AVE STE 145Marina Del Rey, CA 90292-6385
Mailing Address3202 Rosemead PlRosemead, CA 91770-2848 · (626) 283-1826
Phone(310) 405-0595
Sole ProprietorYes
Enumeration DateJuly 2, 2022
Last NPPES UpdateSeptember 1, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2026
✔ NPI 1619600194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 62966
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.
4551 GLENCOE AVE STE 145, Marina Del Rey, CA 90292
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Secondary Practice Location 1

Location 1120 W Hellman AveMonterey Park, CA 91754-1209 · Phone (626) 282-0261

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jamie Phan Pa-c 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 90292 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 15

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

LUKE MACYSZYN MD INC
Neurological Surgery
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (424) 835-3100
LEIA RISPOLI MD, INC.
Physical Medicine & Rehabilitation (Pain Medicine)
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (310) 405-0595
DR. LUKE MACYSZYN MD, MA
Neurological Surgery
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (424) 835-3100
LRNM MEDICAL
Physical Medicine & Rehabilitation
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (310) 405-0595
SHORE ORTHOPEDICS A PROFESSIONAL CORPORATION
Orthopaedic Surgery (Sports Medicine)
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (949) 988-7800
NATASHA CHAND MEHTA M.D.
Physical Medicine & Rehabilitation
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (310) 997-2766
BRETT I. SHORE MD
Orthopaedic Surgery (Sports Medicine)
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (888) 778-5000
SHORE HIP AND JOINT
Orthopaedic Surgery (Sports Medicine)
4551 GLENCOE AVE STE 145
MARINA DEL REY, CA 90292
Los Angeles County (310) 773-3427

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 Jamie Phan's NPI number?

The NPI number for Jamie Phan is 1619600194. It was assigned to this individual provider in the NPPES registry on July 2, 2022.

Where is Jamie Phan located?

Jamie Phan practices at 4551 Glencoe Ave Ste 145, Marina Del Rey, CA 90292. The listed phone number is (310) 405-0595.

What is Jamie Phan's specialty?

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

Is Jamie Phan enrolled in Medicare?

Yes. Jamie Phan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jamie Phan was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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.