Individual provider Active NPI

Lisa Dianne Hineman, N.P.

  • Adult Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1043375785
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NPF 13556 Issued in CA
Practice address
1245 Wilshire Blvd Ste 303
Los Angeles, CA 90017-4803
Phone
(213) 977-1214
Fax
(213) 482-8868
NPI assigned
Dec 22, 2006
Last updated
Jan 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NPF 13556 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd Ste 303
Los Angeles, CA 90017-4803

Mailing address

541 W Colorado St Ste 205
Glendale, CA 91204-3640
Phone (323) 254-0046

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
I20190605003403 CA Practitioner - Nurse Practitioner 8022341007 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13556CAMDMedical Physician Assistant
NPF 13556CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Hematology-Oncology Medical Group CurrentSince Jan 1, 2019 Accepting new patients
Los Angeles Hematology-Oncology Medical Group CurrentSince Jan 1, 2019 Accepting new patients
Los Angeles Cardiology Associates Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 103
Anaheim, CA 92801
Phone (714) 535-3660

260 E Ontario Ave
Ste 101
Corona, CA 92879
Phone (951) 268-7746

1505 Wilson Ter
Ste 200
Glendale, CA 91206
Phone (818) 243-0477

541 W Colorado St
Ste 205
Glendale, CA 91204
Phone (323) 254-0046

1245 Wilshire Blvd
Ste 303
Los Angeles, CA 90017
Phone (213) 977-1214

15211 Vanowen St
Ste 201
Van Nuys, CA 91405
Phone (818) 574-3798

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1043375785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLORADO ST STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043640",
            "telephone_number": "323-254-0046",
            "fax_number": "323-488-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174803",
            "telephone_number": "213-977-1214",
            "fax_number": "213-482-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINEMAN",
        "first_name": "LISA",
        "middle_name": "DIANNE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NPF 13556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.