Individual provider Active NPI

Luke Xavier, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1356982680
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-2983 Issued in HI
Practice address
1625 Schrader Blvd FL 4
Los Angeles, CA 90028-6213
Phone
(323) 993-7500
Fax
(323) 308-4456
NPI assigned
Oct 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-2983 HI Primary

Addresses

Primary practice location

1625 Schrader Blvd FL 4
Los Angeles, CA 90028-6213

Mailing address

1625 Schrader Blvd FL 4
Los Angeles, CA 90028-6213
Phone (208) 699-6129

Other names 1

  • Luke Stormogipson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201218002198 HI Practitioner - Nurse Practitioner 1850703604 Reassigns benefits to 1 organization
I20240102002255 CA Practitioner - Nurse Practitioner 1850703604 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Jan 4, 2021 Accepting new patients
Los Angeles LGBT Center CurrentSince Dec 19, 2023 Accepting new patients
Sud Specialty Group - Ca Psychiatry CurrentSince Aug 1, 2025 Accepting new patients
Los Angeles LGBT Center Psychiatry CurrentSince Dec 19, 2023 Accepting new patients
The Queen'S Medical Center Current Accepting new patients
The Queens Medical Center CurrentSince Jan 4, 2021 Accepting new patients

Locations

1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400

1625 Schrader Blvd
Fl 4
Los Angeles, CA 90028
Phone (323) 993-7500

1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

91-2141 Fort Weaver Rd
Ewa Beach, HI 96706
Phone (808) 678-7000

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

Organizations & group practices 6

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": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1356982680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "208-699-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7500",
            "fax_number": "323-308-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XAVIER",
        "first_name": "LUKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-08",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "HI",
            "license": "APRN-2983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUKE",
            "last_name": "STORMOGIPSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.