Individual provider Active NPI

Sherwin Imperio, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1225565104
Registry record updated Aug 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95006543 Issued in CA
Practice address
4525 E Atherton St
Long Beach, CA 90815
Phone
(562) 961-0155
Fax
(562) 961-0161
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95006543 CA Primary

Addresses

Primary practice location

4525 E Atherton St
Long Beach, CA 90815

Mailing address

PO Box 8111
Long Beach, CA 90808-0111

Other practice location 1

2411 W La Palma Ave
Anaheim, CA 92801-2639
Phone (714) 782-1700

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
I20180207002330 CA Practitioner - Nurse Practitioner 2264792423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Roads Foundation, IncGroup PAC ID 2961722558, 57 clinicians

Practice addresses (Care Compare)

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95006543CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Roads Foundation, Inc. CurrentSince Mar 1, 2024 Accepting new patients
The Roads Foundation, Inc Past Accepting new patients

Locations

121 S Long Beach Blvd
Compton, CA 90221
Phone (310) 627-5850

4525 E Atherton St
Long Beach, CA 90815
Phone (562) 961-0155

4800 E Los Coyotes Diagonal
Long Beach, CA 90815
Phone (310) 627-5850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD
  • Direct secure messaging: sherwin.imperio@rccc.eclinicaldirectplus.com

Organizations & group practices 2

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535241600000",
    "number": "1225565104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8111",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908080111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 E ATHERTON ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90815",
            "telephone_number": "562-961-0155",
            "fax_number": "562-961-0161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2411 W La Palma Ave",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928012639",
            "country_code": "US",
            "telephone_number": "714-782-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMPERIO",
        "first_name": "SHERWIN",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2018-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95006543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.