Tamila Mustafaeva, AGACNP - BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95029674 Issued in CA

Practice address

425 N Jackson St Apt 7
Glendale, CA 91206-3277

Phone

(818) 636-4770

NPI assigned

May 22, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

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, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Pulmonary Consultants and Wellness Center Inc PCGroup PAC ID 9830418342, 29 clinicians

Southern California Multi-Specialty Center IncGroup PAC ID 4082953336, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Pulmonary Consultants and Wellness Center Inc PC

  • Internal Medicine Physician
  • Inglewood, CA
  • NPI 1427440304
  Medicare reassignment Care Compare group NPD
• Southern California Multi-Specialty Center Inc

  • Surgery Physician
  • Sherman Oaks, CA
  • NPI 1407326606
  Medicare reassignment Care Compare group NPD
• Life Tree Community Health Center, Inc.

  • Community Health Clinic/Center
  • Van Nuys, CA
  • NPI 1386413888
  Medicare reassignment NPD
• Southern California Multi-Specialty Center Inc

  • Surgery Physician
  • Tarzana, CA
  • NPI 1730863804
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Centinela, LLC

  • General Acute Care Hospital
  • Inglewood, CA
  • NPI 1336328244
  Care Compare affiliation

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1043059769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N JACKSON ST APT 7",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063277",
            "telephone_number": "818-636-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N JACKSON ST APT 7",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063277",
            "telephone_number": "818-636-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFAEVA",
        "first_name": "TAMILA",
        "credential": "AGACNP - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95029674",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95029674",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "CA",
            "license": "95029674",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95029674",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95029674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Murphy
• Trisha Murray
• Murzik Home Health Care Inc
• Varand Musakhanyan
• Dina Amin Mustafa, PHARMD
• Gevorg Arutyunavich Mutafyan, MD
• Joseph A. Mutch, M.D.
• Charles Bongcawel Mutia, PHYSICAL THERAPY
• My Choice Therapy
• My Genius Lab LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.