Individual provider Active NPI

Delali Aku Manah Ladzekpo, FNP-BC

  • Nurse Practitioner
  • Panorama City, CA
National Provider Identifier
1235657354
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95019127 Issued in CA
Practice address
14850 Roscoe Blvd
Panorama City, CA 91402-4618
Phone
(818) 787-2222
NPI assigned
Sep 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95118483 CA
Nurse Practitioner 363L00000X 95019127 CA Primary

Addresses

Primary practice location

14850 Roscoe Blvd
Panorama City, CA 91402-4618

Mailing address

14850 Roscoe Blvd
Panorama City, CA 91402-4618
Phone (661) 803-4500

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
I20230331000848 CA Practitioner - Nurse Practitioner 9436524667 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95118483CAMDPsychiatric/Mental Health Registered Nurse
95019127CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Medical Solutions Inc a Medical Group CurrentSince Dec 22, 2022 Accepting new patients

Locations

8920 Wilshire Blvd
Ste 310
Beverly Hills, CA 90211
Phone (310) 256-2426

14860 Roscoe Blvd
Ste 200
Panorama City, CA 91402
Phone (818) 830-7751

14850 Roscoe Blvd
Van Nuys, CA 91402
Phone (818) 787-2222

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": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1235657354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14850 ROSCOE BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024618",
            "telephone_number": "661-803-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14850 ROSCOE BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024618",
            "telephone_number": "818-787-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADZEKPO",
        "first_name": "DELALI",
        "middle_name": "AKU MANAH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95118483",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95019127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.