Individual provider Active NPI

Gregory Eric Nawalanic, PSY.D

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1326369778
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28351 Issued in CA
Practice address
10801 National Blvd
Suite 611
Los Angeles, CA 90064-4170
Phone
(310) 273-4843
Fax
(310) 273-5056
NPI assigned
Jun 21, 2010
Last updated
Jun 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY28351 CA Primary

Addresses

Primary practice location

10801 National Blvd
Suite 611
Los Angeles, CA 90064-4170

Mailing address

10801 National Blvd
Suite 611
Los Angeles, CA 90064-4170
Phone (310) 273-4843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009003303 KS Practitioner - Clinical Psychologist 6608168984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-1227

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28351CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Oct 1, 2018 Accepting new patients
Kansas University Physicians Inc CurrentSince Oct 1, 2018 Accepting new patients
Brian Wu MD PHD Inc PastSince Oct 1, 2024 Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-3974

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1326369778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 NATIONAL BLVD",
            "address_2": "SUITE 611",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900644170",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 NATIONAL BLVD",
            "address_2": "SUITE 611",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900644170",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWALANIC",
        "first_name": "GREGORY",
        "middle_name": "ERIC",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.