Individual provider Active NPI

Diane Elizabeth Estanislao, CRNA

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
National Provider Identifier
1043847171
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95001364 Issued in CA
Practice address
1500 San Pablo St
Los Angeles, CA 90033-5313
Phone
(323) 442-7400
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA95001364 CA Primary

Addresses

Primary practice location

1500 San Pablo St
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-7400

Other practice location 1

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

Other names 1

  • Diane Elizabeth Inocencio Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diane.estanislao@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200713001663 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850689282 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

1500 E Duarte Rd
Duarte, CA 91010-3012

209 Fair Oaks Ave
South Pasadena, CA 91030-1814
Phone (626) 396-2900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NA95001364CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation CurrentSince May 1, 2023 Accepting new patients
Aveeva Hospice CurrentSince Apr 15, 2016 Accepting new patients
San Gabriel Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2021 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 7, 2020 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 7, 2020 Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

288 N Santa Anita Ave
Ste 404
Arcadia, CA 91006
Phone (626) 289-2223

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

400 N Pepper Ave
Fl 2
Colton, CA 92324
Phone (909) 580-2440

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

44139 Monterey Ave
Ste B
Palm Desert, CA 92260
Phone (760) 773-4411

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aveeva HospiceRiverside, CA, CCN A01500 Hospice 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
Apr 15, 2016
Apr 15, 2016
Apr 15, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1043847171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Duarte Rd",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "910103012",
            "country_code": "US",
            "telephone_number": "626-256-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTANISLAO",
        "first_name": "DIANE",
        "middle_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95001364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diane.estanislao@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 San Pablo St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "INOCENCIO",
            "middle_name": "ELIZABETH",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.