Neuroelite Services LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

NEUROELITE SERVICES LLC

Practice address

813 N Lenz Dr
Anaheim, CA 92805-1728

Phone

(562) 412-1454

NPI assigned

Aug 29, 2023

Organization subpart

No

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

Authorized official

Name

Marion Echenique

Title

Owner

Phone

(562) 412-1454

Specialties & licenses 1

Addresses

Other names 1

• Neuroelite Services LLC Other name

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.

• Ryan Fillmore, M.D.

  • Neurocritical Care Physician
  • Charlotte, NC
  • NPI 1184043283

  CA, Clinical Neurophysiology

  Medicare reassignment NPD
• Shawn Richmond

  • Technician/Technologist
  • Anaheim, CA
  • NPI 1649605411
  NPD

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1336924133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 N LENZ DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928051728",
            "telephone_number": "562-412-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 N LENZ DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928051728",
            "telephone_number": "562-412-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROELITE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "ECHENIQUE",
        "authorized_official_first_name": "MARION",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-412-1454"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuroelite Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Edward Macrohon Nepomuceno, M.D.
• Tristan Steven Neptune, RADT
• Nanie Ner, PT
• Christopher Nerio
• Michael B. Nestor, MD
• Neuroguard Pro
• Neurology Associates Medical Group
• Daniel Nevarez, ATC
• New Essence Recovery
• New Haven Hospice Care, Inc

• Clinical Neurophysiology Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Clinical Neurophysiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.