Individual provider Active NPI

Marissa Jane Nelson

  • Gerontology Nurse Practitioner
  • Whittier, CA
National Provider Identifier
1366072340
Registry record updated Jan 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95013405 Issued in CA
Practice address
8704 La Entrada Ave
Whittier, CA 90605-1608
Phone
(562) 322-6574
NPI assigned
Jan 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95013405 CA Primary

Addresses

Primary practice location

8704 La Entrada Ave
Whittier, CA 90605-1608

Mailing address

8704 La Entrada Ave
Whittier, CA 90605-1608
Phone (562) 322-6574

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
I20200427000342 CA Practitioner - Nurse Practitioner 6305276759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pih Health PhysiciansGroup PAC ID 8426951328, 616 clinicians

Practice addresses (Care Compare)

12214 Lakewood Blvd
Suite 110
Downey, CA 90242-2663
Phone (562) 904-4430

12675 La Mirada Blvd
Suite 201And401
La Mirada, CA 90638-2200
Phone (562) 903-7339

Hospital & facility affiliations

  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169
  • Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians CurrentSince Mar 30, 2020 Accepting new patients
Pih Health Physicians CurrentSince Mar 30, 2020 Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients
Bright Medical Associates, Inc. Past Accepting new patients

Locations

12214 Lakewood Blvd
Ste 110
Downey, CA 90242
Phone (562) 862-2775

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

Interoperability endpoints

  • Direct secure messaging: marissanelson@pihh.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1579305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579305600000",
    "number": "1366072340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8704 LA ENTRADA AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051608",
            "telephone_number": "562-322-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8704 LA ENTRADA AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051608",
            "telephone_number": "562-322-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARISSA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-18",
        "last_updated": "2020-01-18",
        "certification_date": "2020-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95013405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.