Individual provider Active NPI

Bernadette Nash, PAC

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1356675979
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20536 Issued in CA
Practice address
5900 W Olympic Blvd
Los Angeles, CA 90036-4671
Phone
(323) 932-5000
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20536 CA Primary

Addresses

Primary practice location

5900 W Olympic Blvd
Los Angeles, CA 90036-4671

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2663

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091102000540 CA Practitioner - Physician Assistant 5193862654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20536CAMDPhysician Assistant
20536CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Oct 1, 2009 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1356675979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364671",
            "telephone_number": "323-932-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "BERNADETTE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.