Panthea Pedoeim, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

21298 Issued in CA

Practice address

5353 Balboa Blvd Ste 104
Encino, CA 91316-2858

Phone

(818) 789-7181

NPI assigned

Oct 9, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Scottsdale Physicians Group PLC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1689799579
  NPD
• United Telehealth Corp

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1760036966
  NPD

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1376895847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD STE 104",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162858",
            "telephone_number": "818-789-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD STE 104",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162858",
            "telephone_number": "818-789-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDOEIM",
        "first_name": "PANTHEA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "21298",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "21298",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Acute Care Medical Associates, Inc.
• Pediatric and Family Medical Center
• Pediatric Cardiology Medical Assoc. of So. California
• Pediatric Care Physicians a Professional Medical Corporation
• Pediatric Gastroenterology Medical Center, Inc.
• Michael Pedram, DDS, MD
• Frida Danitza Peinado
• Ifat Peled, PHD
• Michelle Pellegrino, BCBA
• Howard L Pelta, DC

• Pediatric Nurse Practitioner in Encino, CA
• Providers in Encino, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.