Individual provider Active NPI

Mariam Fazil-Nageer, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newport Beach, CA
National Provider Identifier
1235827429
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95024966 Issued in CA
Practice address
1401 Dove St Ste 420
Newport Beach, CA 92660-2420
Phone
(949) 945-0927
NPI assigned
Apr 26, 2023
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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 95024966 CA Primary

Addresses

Primary practice location

1401 Dove St Ste 420
Newport Beach, CA 92660-2420

Mailing address

1401 Dove St Ste 420
Newport Beach, CA 92660-2420
Phone (949) 945-0927

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
I20230718002080 CA Practitioner - Nurse Practitioner 5597125849 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oc Progressive Recovery Inc.Group PAC ID 7214207190, 21 clinicians
Brainpower Wellness Institute Nursing CorporationGroup PAC ID 3072840586, 20 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

2230 W Chapman Ave
Orange, CA 92868-2316

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Progressive Recovery Inc CurrentSince Aug 1, 2023 Accepting new patients
Psychbright Health CurrentSince Oct 10, 2023 Accepting new patients
Amygdala Medical Corporation Psychiatric/Mental Health CurrentSince Dec 12, 2023 Accepting new patients
Brainpower Wellness Institute Nursing Corporation Psychiatric/Mental Health CurrentSince Dec 12, 2023 Accepting new patients
Brainiac Medical Corporation Psychiatric/Mental Health CurrentSince Nov 1, 2025 Accepting new patients

Locations

160 S Old Springs Rd
Ste 135C
Anaheim, CA 92808

160 S Old Springs Rd
Ste 135D
Anaheim, CA 92808
Phone (714) 712-0711

3350 W Ball Rd
Anaheim, CA 92804
Phone (714) 220-4533

9531 Santa Monica Blvd
Beverly Hills, CA 90210

1007 E Cooley Dr
Ste 111
Colton, CA 92324
Phone (909) 429-3244

1101 California Ave
Ste 100
Corona, CA 92881
Phone (714) 584-9700

1101 California Ave
Ste 10018
Corona, CA 92881
Phone (714) 712-0711

1180 S Beverly Dr
Ste 700
Los Angeles, CA 90035
Phone (213) 584-2331

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1310 W Stewart Dr
Ste 301
Orange, CA 92868
Phone (714) 712-0711

2230 W Chapman Ave
Ste 210C
Orange, CA 92868
Phone (714) 248-3764

2230 W Chapman Ave
Ste 212
Orange, CA 92868
Phone (714) 712-0711

2230 W Chapman Ave
Ste 214B
Orange, CA 92868
Phone (714) 712-0711

2599 E 28th St
Ste 206
Signal Hill, CA 90755
Phone (562) 231-7174

3655 Torrance Blvd
Ste 301
Torrance, CA 90503
Phone (714) 712-0711

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1235827429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 DOVE ST STE 420",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602420",
            "telephone_number": "949-945-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DOVE ST STE 420",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602420",
            "telephone_number": "949-945-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIL-NAGEER",
        "first_name": "MARIAM",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95024966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.