Individual provider Active NPI

Nitin Nanda, M.D.

  • Psychiatry Physician
  • Sherman Oaks, CA
National Provider Identifier
1225076748
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A56386 Issued in CA
Practice address
5000 Van Nuys Blvd
Suite 202
Sherman Oaks, CA 91403-1793
Phone
(818) 907-1480
Fax
(818) 907-1481
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A56386 CA Primary

Addresses

Primary practice location

5000 Van Nuys Blvd
Suite 202
Sherman Oaks, CA 91403-1793

Mailing address

5000 Van Nuys Blvd
Suite 202
Sherman Oaks, CA 91403-1793
Phone (818) 907-1480

Other identifiers 2

IdentifierTypeStateIssuer
00A563862MedicaidCA
260044488OtherCARAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031117000943 CA Practitioner - Geriatric PsychiatryPractitioner - Psychiatry 5496669129 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Heritage Medical Group Inc CurrentSince Jan 3, 2015 Accepting new patients

Locations

5016 Chesebro Rd
Ste 200
Agoura Hills, CA 91301
Phone (818) 528-6166

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

3625 E Thousand Oaks Blvd
Ste 232
Westlake Village, CA 91362
Phone (818) 518-9715

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1225076748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 VAN NUYS BLVD",
            "address_2": "SUITE 202",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031793",
            "telephone_number": "818-907-1480",
            "fax_number": "818-907-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 VAN NUYS BLVD",
            "address_2": "SUITE 202",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031793",
            "telephone_number": "818-907-1480",
            "fax_number": "818-907-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDA",
        "first_name": "NITIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A56386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A563862",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260044488",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.