JASON BOMBALES LASALA NP
NPI 1821744178
Nurse Practitioner - Psychiatric/Mental Health in Gardena, CA

Q: What is Jason Lasala's NPI number?

The NPI number for Jason Lasala is 1821744178. It was assigned to this individual provider in the NPPES registry on February 25, 2022.

Q: What is Jason Lasala's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Jason Lasala was last updated on July 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since February 25, 2022PECOS EnrolledAccepts Medicare Assignment

1225 W 190TH ST STE 280, GARDENA, CA 90248(310) 515-8113(310) 538-2102 Get Directions Write a Review

NPPES record last updated: July 19, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 19, 2022, Feb 25, 2022 (2 updates tracked since 2022).

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About Jason Bombales Lasala Np NPPES

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

JASON BOMBALES LASALA NP (NPI 1821744178) is an individual psychiatric/mental health provider in Gardena, California, licensed in California (95018499) and active in the NPI registry since February 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Gabriel, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1821744178

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameJASON BOMBALES LASALACredential: NP

Location Address1225 W 190TH ST STE 280Gardena, CA 90248-4305

Mailing Address1225 W 190th St Ste 280Gardena, CA 90248-4305 · (310) 515-8113 · Fax (310) 538-2102

Phone(310) 515-8113

Fax(310) 538-2102

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 25, 2022

Last NPPES UpdateJuly 19, 20222 updates tracked since enumeration

NPPES CertifiedJuly 19, 2022

✔ NPI 1821744178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95018499

1225 W 190TH ST STE 280, Gardena, CA 90248

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Secondary Practice Location 1

Location 1438 W Las Tunas DrSan Gabriel, CA 91776-1216 · Phone (626) 289-5454

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

Jason Bombales Lasala Np 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 ID3375921323

PECOS Enrollment IDI20220602001742

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 Jason Lasala reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ehab Yacoub MD Inc.

Same address

Child & Adolescent Psychiatry

1225 W 190TH ST STE 280
Gardena, CA 90248

Reassigned Medicare billing, California enrollment
375 clinicians in this Medicare group

NPI 1417373713 (310) 515-8113

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 90248 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. JUAN CRISTOBAL RONDEAU MD

Psychiatry & Neurology (Psychiatry)