Nessrien Waguih Malak

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95025018 Issued in CA

Practice address

3340 Honolulu Ave Apt 6
Glendale, CA 91214-4110

Phone

(562) 507-6012

NPI assigned

Aug 29, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. John's Community HealthGroup PAC ID 2961482690, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: nessrien.malak@sjch.eclinicaldirectplus.com

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.

• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  Medicare reassignment Care Compare group NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1285874826
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1780376947
  NPD (past)

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1013792951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 HONOLULU AVE APT 6",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912144110",
            "telephone_number": "562-507-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 HONOLULU AVE APT 6",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912144110",
            "telephone_number": "562-507-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAK",
        "first_name": "NESSRIEN",
        "middle_name": "WAGUIH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Majestic Home Health Care Services, Inc.
• Amir Majied-Muhammad
• Major Medical Management, Inc. (Valley Regional Surgery Center)
• Mak Hospice Inc
• Therese Makhoul
• Leyla Malakian, D.C.
• Jacquiline P. Malanog, OTR
• Darwin J Maldonado
• Destiny M Maldonado
• Juan Carlos Maldonado

• Family Nurse Practitioner in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.