Individual provider Active NPI

Renato Patiag, MSN, FNP-C

  • Family Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1093373334
Registry record updated Jun 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010380 Issued in CA
Practice address
2701 W Alameda Ave Ste 200
Burbank, CA 91505-4406
Phone
(818) 853-9659
NPI assigned
Jun 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010380 CA Primary

Addresses

Primary practice location

2701 W Alameda Ave Ste 200
Burbank, CA 91505-4406

Mailing address

1455 N Pass Ave
Burbank, CA 91505-2014

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
I20210401001082 CA Practitioner - Nurse Practitioner 2466869789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2701 W Alameda Ave
Suite 200
Burbank, CA 91505-4406

Hospital & facility affiliations

  • Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as apm
Quality
84.3
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010380CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince Aug 15, 2024 Accepting new patients
Providence Medical Institute Current Accepting new patients
Providence Medical Institute CurrentSince Aug 15, 2024 Accepting new patients

Locations

2701 W Alameda Ave
Ste 200
Burbank, CA 91505
Phone (818) 843-1700

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

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.

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": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559433600000",
    "number": "1093373334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 N PASS AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W ALAMEDA AVE STE 200",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054406",
            "telephone_number": "818-853-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIAG",
        "first_name": "RENATO",
        "name_prefix": "Mr.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-02",
        "last_updated": "2019-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.