Individual provider Active NPI

Nathan Dinitz

  • Basic Emergency Medical Technician
  • Palo Alto, CA
National Provider Identifier
1104447432
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
E113847 Issued in CA
Practice address
4178 Wallis CT
Palo Alto, CA 94306-3821
Phone
(650) 999-1442
NPI assigned
Apr 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X E113847 CA Primary

Addresses

Primary practice location

4178 Wallis CT
Palo Alto, CA 94306-3821

Mailing address

4178 Wallis CT
Palo Alto, CA 94306-3821

Other identifiers 1

IdentifierTypeStateIssuer
E113847OtherCAEMERGENCY MEDICAL SERVICES AUTHORITY, CALIFORNIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Nathan@ProMedSolutions.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E113847CAMDBasic Emergency Medical Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1104447432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4178 WALLIS CT",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943063821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4178 WALLIS CT",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943063821",
            "telephone_number": "650-999-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINITZ",
        "first_name": "NATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E113847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMERGENCY MEDICAL SERVICES AUTHORITY, CALIFORNIA",
            "identifier": "E113847",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nathan@ProMedSolutions.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4178 Wallis Ct",
            "city": "Palo Alto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "943063821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.