DR. LYSANDER JIM M.D.
NPI 1457642795
Physical Medicine & Rehabilitation in Pasadena, CA
NPI Status: Active since April 20, 2011
Contact Information
452 N ALTADENA DR UNIT 200
PASADENA, CA
ZIP 91107
Phone: (626) 838-5485
- Individual
- Male
- Physical Medicine & Rehabilitation
- PECOS Enrolled
About LYSANDER JIM
This page provides the complete NPI Profile along with additional information for Lysander Jim, a provider established in Pasadena, California with a medical specialization in Physical Medicine & Rehabilitation. The healthcare provider is registered in the NPI registry with number 1457642795 assigned on April 2011. The practitioner's primary taxonomy code is 208100000X with license number A124122 (CA). The provider is registered as an individual and his NPI record was last updated 8 years ago.
- NPI
- 1457642795
- Provider Name
- DR. LYSANDER JIM M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 452 N ALTADENA DR UNIT 200 PASADENA, CA 91107
- Location Phone
- (626) 838-5485
- Mailing Address
- 601 CAMINO VERDE SOUTH PASADENA, CA 91030
- Mailing Phone
- (626) 297-0400
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-20-2011
- Last Update Date
- 03-21-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Medicine & Rehabilitation
- Taxonomy Code
- 208100000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A124122
- License State
- CA
- Taxonomy Description
- Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Medicare Participation & PECOS Enrollment Status
Lysander Jim is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 5 | 7 | 6 | 4 | 2 | 7 | 9 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 10 | 7 | 12 | 4 | 4 | 7 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 0 + 7 + 1 + 2 + 4 + 4 + 7 + 1 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1457642795 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457642795, enumerated in the NPI registry as an "individual" on April 20, 2011
The provider is located at 452 N Altadena Dr Unit 200 Pasadena, Ca 91107 and the phone number is (626) 838-5485
The provider's speciality is Physical Medicine & Rehabilitation with taxonomy code 208100000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on April 20, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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