Individual provider Active NPI

Kuyann Larissa Thurston, NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1093455388
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95020545 Issued in CA
Practice address
6201 Hollywood Blvd Unit 1510
Los Angeles, CA 90028-5373
Phone
(678) 600-5951
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 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 95020545 CA Primary

Addresses

Primary practice location

6201 Hollywood Blvd Unit 1510
Los Angeles, CA 90028-5373

Mailing address

4055 Lankershim Blvd Apt 334
Studio City, CA 91604-3435
Phone (678) 600-5951

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
I20231107003157 CA Practitioner - Nurse Practitioner 1850748203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
David Taftian DO IncGroup PAC ID 4385980358, 18 clinicians

Practice addresses (Care Compare)

1420 S Central Ave
Glendale, CA 91204-2508
Phone (310) 721-4395

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
90
Improvement activities
40
Cost
31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95020545CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David Taftian DO, Inc CurrentSince Oct 1, 2023 Accepting new patients
Altea Medical California PC CurrentSince Aug 1, 2024 Accepting new patients

Locations (25 of 70)

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

1601 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 292-1241

14475 Garden View Ln
Baldwin Park, CA 91706
Phone (626) 962-7095

1900 Grismer Ave
Burbank, CA 91504
Phone (818) 843-2780

21820 Craggy View St
Chatsworth, CA 91311
Phone (818) 882-2833

10610 Owensmouth Ave
Chatsworth, CA 91311
Phone (818) 458-5597

11900 Ramona Blvd
El Monte, CA 91732
Phone (626) 442-5721

2353 23rd St
Eureka, CA 95501
Phone (704) 445-3261

2321 Newburg Rd
Fortuna, CA 95540
Phone (707) 725-4457

630 W Broadway
Glendale, CA 91204
Phone (818) 247-3395

409 W Glenoaks Blvd
Glendale, CA 91202
Phone (818) 240-3400

1208 S Central Ave
Glendale, CA 91204
Phone (818) 246-5516

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

413 E Cypress St
Glendale, CA 91205
Phone (818) 244-2323

1033 E Arrow Hwy
Glendora, CA 91740
Phone (626) 963-7531

16123 Chatsworth St
Granada Hills, CA 91344
Phone (818) 891-1745

10626 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 368-2802

5696 Lake Murray Blvd
La Mesa, CA 91942
Phone (619) 460-5225

580 S San Vicente Blvd
Los Angeles, CA 90048
Phone (323) 782-1500

1515 N Alexandria Ave
Los Angeles, CA 90027
Phone (214) 986-3010

2070 Century Park E
Los Angeles, CA 90067
Phone (310) 772-4100

517 S A St
Madera, CA 93638
Phone (559) 673-9228

2424 M St
Merced, CA 95340
Phone (209) 723-2442

1255 B St
Merced, CA 95341
Phone (209) 723-8814

1035 W Beverly Blvd
Montebello, CA 90640
Phone (323) 721-6589

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19088/brand/1/csg/1/fhir/r4

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": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1093455388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 LANKERSHIM BLVD APT 334",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916043435",
            "telephone_number": "678-600-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 HOLLYWOOD BLVD UNIT 1510",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900285373",
            "telephone_number": "678-600-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "KUYANN",
        "middle_name": "LARISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.