Individual provider Active NPI

Melanie Suljada, NP

  • Nurse Practitioner
  • Simi Valley, CA
National Provider Identifier
1154986743
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95011057 Issued in CA
Practice address
5924 E Los Angeles Ave Ste R
Simi Valley, CA 93063-5526
Phone
(818) 317-9520
NPI assigned
May 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95011057 CA Primary

Addresses

Primary practice location

5924 E Los Angeles Ave Ste R
Simi Valley, CA 93063-5526

Mailing address

5924 E Los Angeles Ave Ste R
Simi Valley, CA 93063-5526
Phone (818) 317-9520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95011057CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ghods Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1154986743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5924 E LOS ANGELES AVE STE R",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930635526",
            "telephone_number": "818-317-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 E LOS ANGELES AVE STE R",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930635526",
            "telephone_number": "818-317-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULJADA",
        "first_name": "MELANIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95011057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.