Individual provider

Jeffrey Bourne, M.D.

Pediatrics Physician Medicare enrolled

Jeffrey Bourne, M.D. is a Pediatrics Physician in Los Angeles, CA, registered under NPI 1164569091.

Getting there

The practice address on file is 12555 W JEFFERSON BLVD STE 302, Los Angeles, CA 90066. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

12555 W JEFFERSON BLVD STE 302, Los Angeles, CA 90066 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
G86941 CA Pediatrics Physician primary
ME66931 FL Pediatrics Physician

Licences are recorded in 2 states: CA, FL. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Pediatric Medicine
PAC ID
9133403090

Medicare enrolment is recorded as approved under the provider type Practitioner - Pediatric Medicine. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: California and Florida. The practice address on file is in Los Angeles, CA, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

CA California practice address
Licence
G86941
Specialty
Pediatrics Physician
Verify with the CA board →
FL Florida
Licence
ME66931
Specialty
Pediatrics Physician
Verify with the FL board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Pediatrics covers

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. NUCC Health Care Provider Taxonomy, code 208000000X
Allopathic & Osteopathic Physicians Pediatrics

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
208000000X Pediatrics Physician G86941 CA primary
208000000X Pediatrics Physician ME66931 FL

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1164569091 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJan 31, 2007
Last updatedMar 29, 2021
StatusActive
Sole proprietorNo
CredentialM.D.
Practice address 12555 W JEFFERSON BLVD STE 302
Los Angeles, CA 90066
(424) 443-5600
Fax (424) 443-5600
Mailing address 1811 WILSHIRE BLVD STE 110
Santa Monica, CA 90403
The last update on file is Mar 29, 2021. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1164569091 passes the NPI check digit test The final digit 1 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 6 4 5 6 9 0 9
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 3 4 1 6 9 0 9

Sum = 59 · next multiple of 10 = 60 · check digit = 1 · actual last digit = 1

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1164569091?
NPI 1164569091 is the National Provider Identifier assigned to Jeffrey Bourne, M.D. in Los Angeles, CA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Pediatrics Physician cover?
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and…
How do I contact Jeffrey Bourne, M.D.?
The phone number on file with NPPES is (424) 443-5600, last updated Mar 29, 2021. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Jeffrey Bourne, M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1164569091 a valid number?
Yes. 1164569091 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.