Individual provider Active NPI

Nichole Jaleh Panutich, NP

  • Family Nurse Practitioner
  • Newport Beach, CA
National Provider Identifier
1144953928
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F04220441 Issued in CA
Practice address
1 Hoag Dr
Newport Beach, CA 92663-4162
Phone
(949) 764-4624
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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 F04220441 CA Primary

Addresses

Primary practice location

1 Hoag Dr
Newport Beach, CA 92663-4162

Mailing address

23 Liliano
Irvine, CA 92614-5303
Phone (949) 697-9475

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
I20250618001453 CA Practitioner - Nurse Practitioner 1254842032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
BLDG 31
Newport Beach, CA 92663-4162
Phone (949) 650-3350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F04220441CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince May 5, 2025 Accepting new patients

Locations

1 Hoag Dr
Bldg 31
Newport Beach, CA 92663
Phone (949) 650-3350

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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 1

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1144953928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LILIANO",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145303",
            "telephone_number": "949-697-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANUTICH",
        "first_name": "NICHOLE",
        "middle_name": "JALEH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F04220441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.