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JAY D. PRUETZ M.D.
NPI 1790771053
Pediatrics - Pediatric Cardiology in Los Angeles, CA

Active since September 22, 2005PECOS EnrolledAccepts Medicare Assignment
127 S SAN VICENTE BLVD STE A3600, LOS ANGELES, CA 90048(310) 423-1153(310) 423-6795 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jay D. Pruetz M.d. NPPES

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

JAY D. PRUETZ M.D. (NPI 1790771053) is an individual pediatric cardiology provider in Los Angeles, California, licensed in California (A81000) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tarzana, and is a graduate of University Of California, Geffen School Of Medicine (1996).

NPPES Registry Identity

NPI1790771053
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameJAY D. PRUETZCredential: M.D.
Location Address127 S SAN VICENTE BLVD STE A3600Los Angeles, CA 90048-3311
Mailing Address4140 W 190th StTorrance, CA 90504-5513
Phone(310) 423-1153
Fax(310) 423-6795
Sole ProprietorNo
Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 1996
Enumeration DateSeptember 22, 2005
Last NPPES UpdateApril 14, 2026
NPPES CertifiedApril 14, 2026
✔ NPI 1790771053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in CA · A81000
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedPediatricsTaxonomy 208000000X · License A81000 (CA)
127 S SAN VICENTE BLVD STE A3600, Los Angeles, CA 90048
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Secondary Practice Location 1

Location 15411 Etiwanda Ave Ste 250Tarzana, CA 91356-6158 · Phone (310) 423-1153 · Fax (310) 423-6795

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jay D. Pruetz M.d. 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.

PECOS PAC ID7618938556
PECOS Enrollment IDI20041022001137
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.

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.

SALLY A SCHONEFELD M.D.
Surgery (Vascular Surgery)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 423-5400
WASEEM HIJAZI M.D.
Internal Medicine (Cardiovascular Disease)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 423-2726
SUSAN CHENG M.D.
Internal Medicine (Cardiovascular Disease)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 423-2726
ROOPINDER SANDHU MD
Internal Medicine (Clinical Cardiac Electrophysiology)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 248-6679
DAYNA LYN ZIMMERMAN M.D.
Pediatrics (Pediatric Cardiology)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 423-1153
SUNITA KAUR BOPARAI AGACNP-BC
Nurse Practitioner (Acute Care)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 423-3851
DR. MARTHA GULATI MD
Internal Medicine (Cardiovascular Disease)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 423-3977
VICTOR F TAPSON MD
Internal Medicine (Pulmonary Disease)
127 S SAN VICENTE BLVD STE A3600
LOS ANGELES, CA 90048
Los Angeles County (310) 248-8388

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 Jay Pruetz's NPI number?

The NPI number for Jay Pruetz is 1790771053. It was assigned to this individual provider in the NPPES registry on September 22, 2005.

Where is Jay Pruetz located?

Jay Pruetz practices at 127 S San Vicente Blvd Ste A3600, Los Angeles, CA 90048. The listed phone number is (310) 423-1153.

What is Jay Pruetz's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Jay Pruetz enrolled in Medicare?

Yes. Jay Pruetz 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.

When was this NPI record last updated?

The NPPES record for Jay Pruetz was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.