Anne Shaltz

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95013021 Issued in CA

Practice address

8550 Santa Monica Blvd
2ND FL
Los Angeles, CA 90069

Phone

(917) 680-7563

NPI assigned

Oct 24, 2019

Last updated

Oct 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 11, 2021 through Jun 11, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1255974051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 SANTA MONICA BLVD",
            "address_2": "2ND FL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 SANTA MONICA BLVD",
            "address_2": "2ND FL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90069",
            "telephone_number": "917-680-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALTZ",
        "first_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013021",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95013021",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95013021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "95013021",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Marian Shalloe, RN
• Antonio Shallowhorn
• Shalom Pain Treatment Medical Center Inc
• Shalom RX Inc (Western Top Pharmacy)
• Yosef Shaltiel
• Isabel Shalumova
• Shalva, a Psychology Corporation
• Sham Singh, M.D., Inc (Reimagine Psychiatry)
• Bonny Sham, PSY.D.
• Catherine Emily Sham

• Primary Care Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.