Ignacio Marcos Carrillo-Nunez, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A51049 Issued in CA

Practice address

1045 Atlantic Ave
Ste 719
Long Beach, CA 90813-3412

Phone

(562) 591-1324

Fax

(562) 437-1054

NPI assigned

Oct 31, 2005

Last updated

Sep 9, 2016By the provider in NPPES

Sex

Male

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Hospital, Long Beach, CA, CCN 050191
• Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: icarrillonunezmd15297@direct.memorialcare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment Care Compare group NPD
• Ignacio M Carrillo Nunez MD PC

  • Vascular Neurology Physician
  • Fountain Valley, CA
  • NPI 1659720811
  Medicare reassignment Authorized official
• Neurological Institute of Los Angeles

  • Neurology Physician
  • Beverly Hills, CA
  • NPI 1659849040
  Medicare reassignment NPD
• Regents of the University of California

  • Pain Medicine (Anesthesiology) Physician
  • San Diego, CA
  • NPI 1376646869
  Medicare reassignment NPD
• Regents of the University of California

  • Neurology Physician
  • San Diego, CA
  • NPI 1649372673
  Medicare reassignment NPD
• Truong Neuroscience Institute Inc.

  • Neurology Physician
  • Fountain Valley, CA
  • NPI 1952643512
  Medicare reassignment NPD
• Prohealth Partners, a Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Torrance, CA
  • NPI 1841322823
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Regents of the University of California - Ucsd Medical Group

  dba UCSD Dept of Gastroenterology

  • Gastroenterology Physician
  • San Diego, CA
  • NPI 1336267137
  NPD
• Dignity Health

  dba St. Mary Medical Center

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  NPD (past)
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  dba St. Mary Medical Center

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  Care Compare affiliation
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  Care Compare affiliation

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1205827201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST",
            "address_2": "6200",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-378-5516",
            "fax_number": "714-378-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE",
            "address_2": "STE 719",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133412",
            "telephone_number": "562-591-1324",
            "fax_number": "562-437-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO-NUNEZ",
        "first_name": "IGNACIO",
        "middle_name": "MARCOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A51049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Carrell, CCC-SLP
• Sandra Carreon
• Nadine Carreto
• Rasheeka Carriere
• Jasmine M Carrillo-Bautista, ACSW
• Cole Elios Carrillo-Singh
• Ana B Carrillo
• Araceli Flores Carrillo, M.S. PPS
• Barbara Carrillo
• Cristian Paramo Carrillo

• Neurology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.