Nadezhda Protasovitskaya, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95019530 Issued in CA

Practice address

4640 Admiralty Way Ste 500
Marina del Rey, CA 90292-6636

Phone

(888) 880-3451

NPI assigned

Apr 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

University of California, Davis School of Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• May MD Inc.

  • Surgery Physician
  • Culver City, CA
  • NPI 1467037382
  Medicare reassignment NPD
• Global Wound Care Medical Group

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1235831132
  NPD

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1316681802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3958 ALLEGRO CT",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958434865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY STE 500",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926636",
            "telephone_number": "888-880-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTASOVITSKAYA",
        "first_name": "NADEZHDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95019530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura K Pietrzak, PA-C
• Leila Pope
• Michael Port, M.D.
• Prairie Medical Group
• Prostate Oncology Specialists, Inc.
• Carlos Alberto Protzel, LCSW, PSYD
• Providence Healthcare Inc
• Brett Andrew Pugh, DPT
• Moorea Pugliese, PMHNP-BC
• Pure Bodywork

• Nurse Practitioner in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.