Individual provider Active NPI

Misty Cool, D.O.

  • Student in an Organized Health Care Education/Training Program
  • Whittier, CA
National Provider Identifier
1225416654
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
12291 Washington Blvd
Suite 301
Whittier, CA 90606-2500
Phone
(562) 698-0811
NPI assigned
May 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

12291 Washington Blvd
Suite 301
Whittier, CA 90606-2500

Mailing address

12291 Washington Blvd
Suite 301
Whittier, CA 90606-2500
Phone (562) 698-0811

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20180102002710 CA Practitioner - Family Practice 6901164524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

2055 Kellogg Ave
Corona, CA 92879-3111
Phone (866) 984-7483

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15032CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians CurrentSince Nov 4, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 18, 2018 Accepting new patients
Pih Health Physicians CurrentSince Nov 4, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 18, 2018 Accepting new patients

Locations

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

15725 Whittier Blvd
Whittier, CA 90603
Phone (562) 448-1350

Organizations & group practices 5

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1225416654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12291 WASHINGTON BLVD",
            "address_2": "SUITE 301",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062500",
            "telephone_number": "562-698-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12291 WASHINGTON BLVD",
            "address_2": "SUITE 301",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062500",
            "telephone_number": "562-698-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOL",
        "first_name": "MISTY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.