Individual provider Active NPI

Sharmetha Ramanan

  • Pediatric Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1053043034
Registry record updated Aug 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95021790 Issued in CA
Practice address
6677 Santa Monica Blvd Apt 4711
Los Angeles, CA 90038-1994
Phone
(978) 697-6412
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2347915 MA
Pediatric Nurse Practitioner 363LP0200X 95021790 CA Primary

Addresses

Primary practice location

6677 Santa Monica Blvd Apt 4711
Los Angeles, CA 90038-1994

Mailing address

16 Winston Ave
Wilmington, MA 01887-2844
Phone (978) 697-6412

Other practice location 1

16 Winston Ave
Wilmington, MA 01887-2844
Phone (978) 697-6412

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
I20240115000722 CA Practitioner - Nurse Practitioner 8527410679

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2347915MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Affiliates Medical Group Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sramanan698295@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661040000000",
    "number": "1053043034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WINSTON AVE",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872844",
            "telephone_number": "978-697-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 SANTA MONICA BLVD APT 4711",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381994",
            "telephone_number": "978-697-6412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Winston Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "MA",
            "postal_code": "018872844",
            "country_code": "US",
            "telephone_number": "978-697-6412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMANAN",
        "first_name": "SHARMETHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-08-21",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2347915",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95021790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.