JON A DETTERICH MD
NPI 1659518884
Emergency Medicine - Pediatric Emergency Medicine in Los Angeles, CA
About Jon A Detterich Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JON A DETTERICH MD (NPI 1659518884) is an individual pediatric emergency medicine provider in Los Angeles, California, licensed in California (A89834) and active in the NPI registry since January 2009. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Wisconsin (2003).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jon A Detterich Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jon Detterich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Childrens Hospital Los Angeles Medical Group Inc
- 1,281 clinicians in this Medicare group
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 90027 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
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 Jon Detterich's NPI number?
The NPI number for Jon Detterich is 1659518884. It was assigned to this individual provider in the NPPES registry on January 9, 2009.
Where is Jon Detterich located?
Jon Detterich practices at 4650 W Sunset Blvd Ms #113, Los Angeles, CA 90027. The listed phone number is (323) 361-2109.
What is Jon Detterich's specialty?
The primary specialty registered for this NPI is Emergency Medicine, specializing in Pediatric Emergency Medicine, with taxonomy code 207PP0204X.
Is Jon Detterich enrolled in Medicare?
Yes. Jon Detterich is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jon Detterich's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jon Detterich reassigns Medicare benefits to Children's Hospital Los Angeles Medical Group, Inc. (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 Jon Detterich'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 Jon Detterich was last updated on January 9, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Jon A Detterich, MD · NPI 1659518884
Pediatric Emergency Medicine physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since January 9, 2009.
## Identity
- **NPI:** 1659518884 (Entity type: Individual)
- **Enumerated:** January 9, 2009
- **Primary specialty:** Emergency Medicine - Pediatric Emergency Medicine · taxonomy 207PP0204X
- **State license:** A89834 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4650 W SUNSET BLVD, MS #113, Los Angeles, CA 90027-6062
- **Phone:** (323) 361-2109
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Children's Hospital Los Angeles Medical Group, Inc. (NPI 1265530653, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Medical College Of Wisconsin, class of 2003
## Record status
- **NPPES last updated:** January 9, 2009
---
Source: [NPI Profile](https://npiprofile.com/npi/1659518884) · Data from the CMS NPPES public registry.