Individual provider Active NPI

Vincent Angelo Glaviano, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1205207594
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017783 Issued in CA
Practice address
12746 W Jefferson Blvd Ste 3000
Los Angeles, CA 90094-2885
Phone
(424) 315-2395
Fax
(424) 315-2396
NPI assigned
Oct 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2295490 MA
Family Nurse Practitioner 363LF0000X 95017783 CA Primary

Addresses

Primary practice location

12746 W Jefferson Blvd Ste 3000
Los Angeles, CA 90094-2885

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (424) 315-2395

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
I20220128001163 CA Practitioner - Nurse Practitioner 0941509657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

12746 W Jefferson Blvd
Suite 2000
Playa Vista, CA 90094-2776
Phone (424) 315-2220

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 30, 2022 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 30, 2022 Accepting new patients
Mass General Brigham Urgent Care LLC Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

12746 W Jefferson Blvd
Ste 3000
Playa Vista, CA 90094
Phone (424) 314-0440

12746 W Jefferson Blvd
Ste 2000
Playa Vista, CA 90094
Phone (424) 315-2220

12746 W Jefferson Blvd
Ste 300
Playa Vista, CA 90094

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: vglaviano298849@direct.cshs.org

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 2

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": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1205207594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "424-315-2395",
            "fax_number": "424-315-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12746 W JEFFERSON BLVD STE 3000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900942885",
            "telephone_number": "424-315-2395",
            "fax_number": "424-315-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAVIANO",
        "first_name": "VINCENT",
        "middle_name": "ANGELO",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-12",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2295490",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.