Tina Ghiassi, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014455 Issued in CA

Practice address

2900 N Sepulveda Blvd
Manhattan Beach, CA 90266-2730

Phone

(310) 546-3481

NPI assigned

May 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: tina.ghiassi@398008301912068.direct.elationemr.com

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1154944635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662730",
            "telephone_number": "310-546-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662730",
            "telephone_number": "310-546-3481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "843 S State College Blvd",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928064613",
            "country_code": "US",
            "telephone_number": "714-406-1124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHIASSI",
        "first_name": "TINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014455",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95014455",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Geelhoed, PHYSICIAN ASSISTANT
• Genesis Concierge Medicine
• Genesis Family Care Medical Group, Inc.
• Jason K Gentile, M.D.
• Aaron P Gerson, D.D.S.
• Sara Gilbert, MA LMFT
• Amy A Gimlen, DDS MS
• Sandra Gleason, NBC-HWC
• William V Glenn, MD
• Megan Enge Glotz, LMFT

• Family Nurse Practitioner in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.