Individual provider Active NPI

Liliya Shamilyevna Urena, NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1043071087
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95028570 Issued in CA
Practice address
12301 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1000
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Jan 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95028570 CA
Nurse Practitioner 363L00000X 95028570 CA Primary

Addresses

Primary practice location

12301 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1000

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

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
I20240326004288 CA Practitioner - Nurse Practitioner 8820435837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Seniors Group IncGroup PAC ID 1759769151, 53 clinicians

Practice addresses (Care Compare)

12301 Wilshire Blvd
Los Angeles, CA 90025-1000
Phone (310) 500-2045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95028570CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Celebrating Life Community Health Center Current Accepting new patients
Minghsun Liu, M.D., PC CurrentSince Mar 18, 2024 Accepting new patients
One Medical Seniors Group, Inc. CurrentSince Oct 21, 2024 Accepting new patients

Locations

9725 Wilshire Blvd
Beverly Hills, CA 90212
Phone (310) 500-2040

10000 Washington Blvd
Ste 108
Culver City, CA 90232
Phone (310) 500-2045

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

12301 Wilshire Blvd
Ste 100
Los Angeles, CA 90025
Phone (310) 500-2045

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

Interoperability endpoints

  • Direct secure messaging: liliyaurena@clchc.allscriptsdirect.net

Organizations & group practices 3

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": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1043071087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251000",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URENA",
        "first_name": "LILIYA",
        "middle_name": "SHAMILYEVNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028570",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95028570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.