Individual provider Active NPI

Joseph Steven Munizich, FNP-BC

  • Nurse Practitioner
  • Glendora, CA
National Provider Identifier
1093414195
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95024141 Issued in CA
Practice address
646 S Minnesota Ave
Glendora, CA 91740-4456
Phone
(323) 803-8589
NPI assigned
Feb 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95024141 CA Primary

Addresses

Primary practice location

646 S Minnesota Ave
Glendora, CA 91740-4456

Mailing address

646 S Minnesota Ave
Glendora, CA 91740-4456
Phone (323) 803-8589

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
I20241021001169 CA Practitioner - Nurse Practitioner 5597297127 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95024141CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Care Foundation CurrentSince Nov 1, 2024 Accepting new patients
Emanate Health Medical Group Past Accepting new patients

Locations

1041 W Badillo St
Ste 104
Covina, CA 91722
Phone (626) 732-4168

1135 S Sunset Ave
Ste 401
West Covina, CA 91790
Phone (626) 732-8390

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

1135 S Sunset Ave
West Covina, CA 91790
Phone (626) 813-3716

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1093414195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 S MINNESOTA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404456",
            "telephone_number": "323-803-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 S MINNESOTA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404456",
            "telephone_number": "323-803-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZICH",
        "first_name": "JOSEPH",
        "middle_name": "STEVEN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95024141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.