Individual provider Active NPI

Lillian Mary Ghosh, NP

  • Acute Care Nurse Practitioner
  • Sylmar, CA
National Provider Identifier
1174284855
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95018094 Issued in CA
Practice address
13711 Foothill Blvd Unit B
Sylmar, CA 91342-3138
Phone
(818) 408-8008
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95018094 CA Primary

Addresses

Primary practice location

13711 Foothill Blvd Unit B
Sylmar, CA 91342-3138

Mailing address

2512 Hawk St
Simi Valley, CA 93065-2343
Phone (818) 825-4305

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
I20220804003746 CA Practitioner - Nurse Practitioner 1759763873 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Emergency Physicians, Inc.Group PAC ID 9931391604, 16 clinicians

Practice addresses (Care Compare)

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 955-6107

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
72.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95018094CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Emergency Physicians, Inc. CurrentSince Jul 1, 2022 Accepting new patients

Locations

2975 Sycamore Dr
Simi Valley, CA 93065
Phone (805) 522-2500

Organizations & group practices 3

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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1174284855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 HAWK ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652343",
            "telephone_number": "818-825-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13711 FOOTHILL BLVD UNIT B",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913423138",
            "telephone_number": "818-408-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOSH",
        "first_name": "LILLIAN",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2021-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95018094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.