Individual provider Active NPI

Lily Nourmand, M.D.

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1376584482
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A064775 Issued in CA
Practice address
1821 Wilshire Blvd Ste 301
Santa Monica, CA 90403-5679
Phone
(310) 828-6027
Fax
(310) 453-8085
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A064775 CA Primary

Addresses

Primary practice location

1821 Wilshire Blvd Ste 301
Santa Monica, CA 90403-5679

Mailing address

PO Box 4001
Spokane, WA 99210-4001
Phone (866) 747-2455

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lnourmand472807@oc.providencedirect.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615001712 CA Practitioner - Family Practice 6901880111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Un of California, Irvine, College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

1821 Wilshire Blvd
Suite 301
Santa Monica, CA 90403-5679
Phone (310) 828-6027

Hospital & facility affiliations

  • A&M Alliance Home Health Care, Inc. Home health agency, Woodland Hills, CA, CCN 559362
  • Care 4U Home Health Services, Inc. Home health agency, Westlake Village, CA, CCN 758128
  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A064775CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients
Martin L. Alpert, M.D., Inc. Past Accepting new patients

Locations

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

1821 Wilshire Blvd
Ste 301
Santa Monica, CA 90403
Phone (310) 828-6027

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2021 Santa Monica Blvd
Ste 245E
Santa Monica, CA 90404
Phone (310) 829-4403

1831 Wilshire Blvd
Ste A
Santa Monica, CA 90403
Phone (310) 829-8584

Interoperability endpoints

  • Direct secure messaging: lnourmand472807@oc.providencedirect.org

Organizations & group practices 3

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 3

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1376584482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4001",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992104001",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD STE 301",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035679",
            "telephone_number": "310-828-6027",
            "fax_number": "310-453-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURMAND",
        "first_name": "LILY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A064775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lnourmand472807@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1821 Wilshire Blvd Ste 301",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904035679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.