Papr

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PAPR

Practice address

8349 Reseda Blvd Ste G
Northridge, CA 91324-5914

Phone

(818) 886-7300

Fax

(818) 886-8786

NPI assigned

Feb 16, 2023

Last updated

Jun 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacob Poulose, MDNPI 1578723508

Title

Owner

Phone

(818) 321-5377

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Poulose, MD.

  • Nephrology Physician
  • Northridge, CA
  • NPI 1578723508
  Medicare reassignment Care Compare group NPD Authorized official
• Renee Dua, MD

  • Specialist
  • Northridge, CA
  • NPI 1154436707

  Nephrology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1295433415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8349 RESEDA BLVD STE G",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245914",
            "telephone_number": "818-886-7300",
            "fax_number": "818-886-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8349 RESEDA BLVD STE G",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245914",
            "telephone_number": "818-886-7300",
            "fax_number": "818-886-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAPR",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-16",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "POULOSE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-321-5377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1578723508",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory L Palmer, MD
• Rhina Paniagua
• Cristina Paniza
• Maral Papazian
• Agnesa Papazyan, PSY.D.
• Amy Parada
• Lorena Parada
• Paradise Senior Living Inc.
• Paradise Senior Living Inc.
• Paradise Senior Living Inc. (Paradise Senior Living)

• Nephrology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.