Individual provider Active NPI

Gity Qader

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1124612080
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017596 Issued in CA
Practice address
1338 S Hope St
Los Angeles, CA 90015-2902
Phone
(213) 748-2411
NPI assigned
Feb 22, 2021
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017596 CA Primary

Addresses

Primary practice location

1338 S Hope St
Los Angeles, CA 90015-2902

Mailing address

1328 Beaver Way
La Verne, CA 91750-2522

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
I20211129001649 CA Practitioner - Nurse Practitioner 5092105411 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Emergency Physicians Inc Single Specialty CurrentSince Nov 15, 2021 Accepting new patients
Aghaby Comprehensive Community Health Center Single Specialty CurrentSince Oct 25, 2022 Accepting new patients

Locations

349 W Compton Blvd
Compton, CA 90220
Phone (310) 669-9300

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

1845 Civic Center Dr
North Las Vegas, NV 89030
Phone (702) 485-2345

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1124612080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 BEAVER WAY",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 S HOPE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152902",
            "telephone_number": "213-748-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QADER",
        "first_name": "GITY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.