Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Medina Simon

Individual provider Physician Assistant · NPI 1083329841

Jacqueline Medina Simon is a Physician Assistant in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
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Practice location Address checks out

1731 E 120th St
Los Angeles, CA 90059-3051
Phone: (323) 563-4800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1083329841
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 17, 2023
Last updated in NPPESJanuary 17, 2023
Certification dateJanuary 17, 2023

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients13
Services billed 16 a service is one billed item, such as a visit, a test or a procedure
Average patient age54

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

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