Individual provider Active NPI

Dyane Gatmaitan

  • Gerontology Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1104229178
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95001144 Issued in CA
Practice address
127 S San Vicente Blvd # a-6600
Los Angeles, CA 90048-3311
Phone
(310) 423-6472
Fax
(310) 423-8839
NPI assigned
Oct 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95001144 CA
Gerontology Nurse Practitioner 363LG0600X 95001144 CA Primary

Addresses

Primary practice location

127 S San Vicente Blvd # a-6600
Los Angeles, CA 90048-3311

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 423-6472

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
I20160511001626 CA Practitioner - Nurse Practitioner 9537458757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-3277

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Jun 6, 2022 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jun 6, 2022 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Dec 1, 2023 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Dec 1, 2023 Accepting new patients

Locations

8767 Wilshire Blvd
Fl 2
Beverly Hills, CA 90211
Phone (310) 248-7000

8767 Wilshire Blvd
Fl 3
Beverly Hills, CA 90211
Phone (310) 385-6031

127 S San Vicente Blvd
#A6600
Los Angeles, CA 90048
Phone (310) 423-6472

127 S San Vicente Blvd
Ste A6600
Los Angeles, CA 90048
Phone (310) 423-6472

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: dgatmaitan239781@direct.cshs.org
  • Direct secure messaging: dyane.gatmaitan.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 4

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 3

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": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1104229178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "310-423-6472",
            "fax_number": "310-423-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S SAN VICENTE BLVD # A-6600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483311",
            "telephone_number": "310-423-6472",
            "fax_number": "310-423-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATMAITAN",
        "first_name": "DYANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95001144",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95001144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.