Constanza Munoz Kotanko, FNP-BC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95031035 Issued in CA

Practice address

16630 S Broadway
Gardena, CA 90248-2716

Phone

(310) 768-8155

NPI assigned

Aug 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Serenity Care Health Group

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1245623156
  Medicare reassignment NPD
• Serenity Care Health Group

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1902663305
  NPD

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1205660362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16630 S BROADWAY",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902482716",
            "telephone_number": "310-768-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16630 S BROADWAY",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902482716",
            "telephone_number": "310-768-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ KOTANKO",
        "first_name": "CONSTANZA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95031035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Munguia
• Payal Bhavesh Muni
• Jennifer Edith Munive
• Christina Dolores Muniz, N.M.W
• Melanie Valerie Muniz, BCBA
• Alexis Breana Munoz
• Destiny Rina Munoz
• Enez Munoz
• Evelyn Aracely Munoz
• Giselle Munoz

• Family Medicine Physician in Gardena, CA
• Providers in Gardena, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.