Individual provider Active NPI

Somaly Sith, FNP

  • Family Nurse Practitioner
  • Sherman Oaks, CA
National Provider Identifier
1033618293
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013961 Issued in CA
Practice address
4849 Van Nuys Blvd # 202
Sherman Oaks, CA 91403-2110
Phone
(404) 213-0453
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013961 CA Primary

Addresses

Primary practice location

4849 Van Nuys Blvd # 202
Sherman Oaks, CA 91403-2110

Mailing address

11018 Moorpark St Apt 303
North Hollywood, CA 91602-3411
Phone (404) 213-0453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200915002463 AZ Practitioner - Nurse Practitioner 5799103529
I20210624001589 WA Practitioner - Nurse Practitioner 5799103529
I20230905000232 GA Practitioner - Nurse Practitioner 5799103529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Perry Medical Group of Florida PAGroup PAC ID 8729481197, 15 clinicians

Practice addresses (Care Compare)

2111 Centenary Main St
Dacula, GA 30019-2212
Phone (866) 447-3779

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aleracare of Colorado, LLC CurrentSince Aug 1, 2021 Accepting new patients
Perry Medical Group of Florida PA CurrentSince Jul 24, 2023 Accepting new patients

Locations

4045 E Bell Rd
Ste 157
Phoenix, AZ 85032
Phone (602) 404-0015

5350 E High St
Ste 300
Phoenix, AZ 85054
Phone (480) 716-5820

2910 Beacon St
Ste 200
Colorado Springs, CO 80907
Phone (888) 238-9523

750 W Hampden Ave
Ste 285
Englewood, CO 80110
Phone (888) 238-9523

1303 Fortino Blvd
Ste C
Pueblo, CO 81008
Phone (480) 716-5820

150 W 22nd St
Fl 8
New York, NY 10011
Phone (646) 809-4094

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1033618293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11018 MOORPARK ST APT 303",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916023411",
            "telephone_number": "404-213-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 VAN NUYS BLVD # 202",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032110",
            "telephone_number": "404-213-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITH",
        "first_name": "SOMALY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.