Individual provider Active NPI

Megan Puyau, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • El Segundo, CA
National Provider Identifier
1003523838
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95021139 Issued in CA
Practice address
390 N Pacific Coast Hwy Ste 2060
El Segundo, CA 90245-4401
Phone
(855) 427-2778
Fax
(424) 277-6085
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95021139 CA Primary

Addresses

Primary practice location

390 N Pacific Coast Hwy Ste 2060
El Segundo, CA 90245-4401

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (916) 576-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912001153 CA Practitioner - Nurse Practitioner 5294275699 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95021139CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mark David Levine M.D. Professional Corporation Psychiatric/Mental Health CurrentSince Jul 29, 2024 Accepting new patients
Mark David Levine, MD Burlingame PC CurrentSince Jul 29, 2024 Accepting new patients

Locations

390 N Pacific Coast Hwy
Ste 2060
El Segundo, CA 90245

4553 Glencoe Ave
Ste 315
Marina del Rey, CA 90292

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1003523838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "916-576-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N PACIFIC COAST HWY STE 2060",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454401",
            "telephone_number": "855-427-2778",
            "fax_number": "424-277-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUYAU",
        "first_name": "MEGAN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.