Individual provider Active NPI

Sarah Jane Aganan Dy, ACNP

  • Acute Care Nurse Practitioner
  • Sylmar, CA
National Provider Identifier
1144328428
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
15997 Issued in CA
Practice address
14445 Olive View Dr
2B-182 Department of Medicine
Sylmar, CA 91342-1437
Phone
(818) 634-3205
Fax
(818) 362-4573
NPI assigned
Sep 20, 2006
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 15997 CA Primary
Critical Care Medicine Registered Nurse 163WC0200X 15997 CA

Addresses

Primary practice location

14445 Olive View Dr
2B-182 Department of Medicine
Sylmar, CA 91342-1437

Mailing address

5148 Rockland Ave
Los Angeles, CA 90041-1135
Phone (323) 255-5079

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
I20140623002656 CA Order and Referring Only - Nurse Practitioner 6507875903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16858CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1144328428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5148 ROCKLAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411135",
            "telephone_number": "323-255-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "2B-182 DEPARTMENT OF MEDICINE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-634-3205",
            "fax_number": "818-362-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DY",
        "first_name": "SARAH JANE",
        "middle_name": "AGANAN",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "15997",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "15997",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.