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MARTIN LUTHER KING JR. COMMUNITY MEDICAL GROUP
NPI 1639704323
Internal Medicine in Los Angeles, CA

Active since March 03, 2020
12021 WILMINGTON AVE, BUILDING 11, SUITE 1000, LOS ANGELES, CA 90059(424) 529-6755(424) 338-8984 Get Directions Write a Review

NPPES record last updated: May 14, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 14, 2024, Dec 12, 2023, Jan 17, 2023 and 1 more (4 updates tracked since 2020).

About Martin Luther King Jr. Community Medical Group NPPES

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

MARTIN LUTHER KING JR. COMMUNITY MEDICAL GROUP (NPI 1639704323) is a healthcare organization registered as an internal medicine in Los Angeles, California and active in the NPI registry since March 2020. The organization maintains a secondary practice location in Compton and lists Kurt Stauder, President, as its authorized official.

NPPES Registry Identity

NPI1639704323
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMARTIN LUTHER KING JR COMMUNITY MEDICAL FOUNDATION
Location Address12021 WILMINGTON AVE, BUILDING 11, SUITE 1000Los Angeles, CA 90059
Mailing Address2215 W Rosecrans Ave Ste 22Compton, CA 90222-3856 · (424) 338-8760 · Fax (424) 338-8984
Phone(424) 529-6755
Fax(424) 338-8984
Organization SubpartNo
Authorized OfficialKurt StauderPresident · (424) 529-6755
Enumeration DateMarch 3, 2020
Last NPPES UpdateMay 14, 20244 updates tracked since enumeration
NPPES CertifiedMay 6, 2024
✔ NPI 1639704323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedInterpreterTaxonomy 171R00000X
Also ListedCommunity Health WorkerTaxonomy 172V00000X
Also ListedFamily Medicine · Addiction MedicineTaxonomy 207QA0401X
Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X
12021 WILMINGTON AVE, Los Angeles, CA 90059
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Other Names 1

Doing Business AsMartin Luther King Jr. Community Medical Group

Secondary Practice Location 1

Location 12215 W Rosecrans Ave Ste 22Compton, CA 90222-3856 · Phone (424) 338-8760 · Fax (424) 338-8984

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Martin Luther King Jr. Community Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

547

Medicare enrollment records show 547 clinicians reassign Medicare billing to Martin Luther King Jr. Community Medical Group, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 65 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 30

Diagnostic Radiology288
Anesthesiology49
Certified Registered Nurse Anesthetist (CRNA)44
Psychiatry44
Internal Medicine19
Interventional Radiology16
Nurse Practitioner13
Family Practice9
22 other specialties65

Nearest to this location (20)

See all 547
Virginia Adewole, MD
Internal Medicine
NPI 1639512239
12021 WILMINGTON AVE BLDG 11 STE. 1000
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts MedicareSame address
Erin Dizon, M.D.
Infectious Disease
NPI 1215336136
12021 WILMINGTON AVE STE 1000
Los Angeles, CA 90059
(424) 296-3976
✔ PECOS✔ Accepts MedicareSame address
Megan Jacobs, MD
Endocrinology
NPI 1689685885
12021 WILMINGTON AVE STE 1000
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts MedicareSame address
Eriko Masuda, MD
Infectious Disease
NPI 1992123095
12021 WILMINGTON AVE STE 1000
Los Angeles, CA 90059
(424) 529-6577
✔ PECOS✔ Accepts MedicareSame address
James Pinney, M.D., PH.D.
Internal Medicine
NPI 1124480124
12021 WILMINGTON AVE. BLDG 11 SUITE1000
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts MedicareSame address
Shreya Pujara, MD
Endocrinology
NPI 1154611192
12021 WILMINGTON AVE STE 1000
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts MedicareSame address
Augustine Pyo
Cardiovascular Disease (Cardiology)
NPI 1255741005
12021 WILMINGTON AVE BLDG 11, SUITE 1000
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts MedicareSame address
David Tobey, D.O.
Vascular Surgery
NPI 1528324381
12021 WILMINGTON AVE STE 1000 SUITE1000
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts MedicareSame address
Adan De Jesus Romero Lopez, MD
Family Practice
NPI 1033520002
12021 WILMINGTON AVE BLDG 11
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts Medicare0.1 mi
Sarat Varghese, MD
Family Practice
NPI 1104261106
1680 E 120TH ST
Los Angeles, CA 90059
(925) 225-5837
✔ PECOS✔ Accepts Medicare0.1 mi
Jessie Alvarez, PMHNP-BC
Nurse Practitioner
NPI 1699510719
1680 E 120TH ST
Los Angeles, CA 90059
(424) 338-8000
✔ PECOS0.1 mi
Robert Andalon, MD
Internal Medicine
NPI 1285321182
1680 E 120TH ST
Los Angeles, CA 90059
(424) 338-8000
✔ PECOS✔ Accepts Medicare0.1 mi
Jessica Nunez, LCSW, MPH
Clinical Social Worker
NPI 1992937478
1680 E 120TH ST
Los Angeles, CA 90059
(424) 338-8568
✔ PECOS0.1 mi
Elsa Zecena
Nurse Practitioner
NPI 1649940255
1680 E 120TH ST
Los Angeles, CA 90059
(424) 338-8000
✔ PECOS✔ Accepts Medicare0.1 mi
Stanley Frencher, M.D. M.P.H.
General Surgery
NPI 1124341086
1670 E 120TH ST MODULE 3A, UROLOGY
Los Angeles, CA 90059
(424) 338-1559
✔ PECOS✔ Accepts Medicare0.1 mi
Jason Prasso, M.D.
Critical Care (Intensivists)
NPI 1033435953
12021 WILMINGTON AVE. BLDG 11 SUITE1000
Los Angeles, CA 90059
(424) 529-6755
✔ PECOS✔ Accepts Medicare0.2 mi
Oliver Brooks, M.D.
Pediatric Medicine
NPI 1013013150
10300 COMPTON AVE
Los Angeles, CA 90002
(323) 564-4331
✔ PECOS1.4 mi
Shing Cheng, M.D.
Internal Medicine
NPI 1871948828
2251 W ROSECRANS AVE STE 19
Compton, CA 90222
(424) 338-1000
✔ PECOS✔ Accepts Medicare1.5 mi
Sonali Patel, FNP
Nurse Practitioner
NPI 1306559653
2251 W ROSECRANS AVE STE 18-21
Compton, CA 90222
(424) 529-6755
✔ PECOS✔ Accepts Medicare1.5 mi
Edward Speltie, D.O.
Family Practice
NPI 1558881482
2251 W ROSECRANS AVE STE 18-21
Compton, CA 90222
(424) 529-6755
✔ PECOS1.5 mi
See all 547 clinicians

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

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 Martin Luther King Jr Community Medical Foundation's NPI number?

The NPI number for Martin Luther King Jr Community Medical Foundation is 1639704323. It was assigned to this organization in the NPPES registry on March 3, 2020. The provider is doing business as Martin Luther King Jr. Community Medical Group.

Where is Martin Luther King Jr Community Medical Foundation located?

Martin Luther King Jr Community Medical Foundation is located at 12021 Wilmington Ave Building 11, Suite 1000, Los Angeles, CA 90059. The listed phone number is (424) 529-6755.

What is Martin Luther King Jr Community Medical Foundation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Martin Luther King Jr Community Medical Foundation enrolled in Medicare?

Yes. Martin Luther King Jr Community Medical Foundation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Martin Luther King Jr Community Medical Foundation?

According to the CMS Revalidation Reassignment List (October 2026 release), 547 clinicians in 30 Medicare specialties reassign their Medicare billing to Martin Luther King Jr Community Medical Foundation. 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. The largest specialties are Diagnostic Radiology (288), Anesthesiology (49) and Certified Registered Nurse Anesthetist (CRNA) (44). Of these, 8 practice at this address and 65 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Martin Luther King Jr Community Medical Foundation was last updated on May 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.