Anissa Ellen Spada, NURSE PRACTITIONER

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95005139 Issued in CA

Practice address

2010 E 1St St Ste 100
Santa Ana, CA 92705-4086

Phone

(714) 556-7246

Fax

(714) 556-7247

NPI assigned

Nov 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ehab Yacoub MD Inc.

  dba Brain Health USA

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713
  Medicare reassignment Care Compare group NPD
• Elite Pain Management Inc.

  • Interventional Pain Medicine Physician
  • Santa Ana, CA
  • NPI 1346449394
  Medicare reassignment NPD

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1114469111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054086",
            "telephone_number": "714-556-7246",
            "fax_number": "714-556-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054086",
            "telephone_number": "714-556-7246",
            "fax_number": "714-556-7247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11180 Warner Ave",
            "address_2": "suite 455",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087501",
            "country_code": "US",
            "telephone_number": "714-893-6008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPADA",
        "first_name": "ANISSA",
        "middle_name": "ELLEN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "95005139",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "9500139",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95005139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern California Sports Rehab Inc
• Southern California Sports Rehabilitation, Inc.
• Southland Integrated Services, Inc. (Integrated Community Services - Santa Ana)
• Praseuth Souvannavong
• Soyeon Kim (Kim's Dental Corporation)
• Sheena Marie Spanskie, APRN-PMHNP
• Tina Sparks
• Spartamed
• John A Spear, D.D.S.
• Damien Joseph Spena

• Acute Care Nurse Practitioner in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.