Individual provider Active NPI

Tina Donaldson, RN, NP

  • Basic Emergency Medical Technician
  • Winnetka, CA
National Provider Identifier
1376934174
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
95001375 Issued in CA
Practice address
20800 Sherman Way
Winnetka, CA 91306-2707
Phone
(818) 715-9031
NPI assigned
Feb 16, 2015
Last updated
Sep 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 95001375 CA Primary

Addresses

Primary practice location

20800 Sherman Way
Winnetka, CA 91306-2707

Mailing address

20800 Sherman Way
El Proyecto del Barrio
Winnetka, CA 91306-2707
Phone (818) 715-9031

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
I20160420002271 CA Practitioner - Nurse Practitioner 7416255633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
El Proyecto del Barrio IncGroup PAC ID 3476546227, 27 clinicians

Practice addresses (Care Compare)

12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531

14624 Sherman Way
FL 6
Van Nuys, CA 91405-2241
Phone (818) 988-6335

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086

20800 Sherman Way
Canoga Park, CA 91306-2707
Phone (818) 883-2273

7107 Remmet Ave
Canoga Park, CA 91303-2016
Phone (818) 340-3570

8902 Woodman Ave
Arleta, CA 91331-6401
Phone (818) 830-7080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95001375CAMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Valley Health Corporation CurrentSince Nov 4, 2017 Accepting new patients
El Proyecto del Barrio, Inc. CurrentSince Mar 13, 2016 Accepting new patients
El Proyecto del Barrio, Inc. CurrentSince Mar 13, 2016 Accepting new patients
Northeast Valley Health Corporation CurrentSince Nov 4, 2017 Accepting new patients
Northeast Valley Health Corporation Current Accepting new patients
El Proyecto del Barrio, Inc. Current Accepting new patients

Locations

8902 Woodman Ave
Arleta, CA 91331
Phone (818) 830-7033

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086

20800 Sherman Way
Winnetka, CA 91306
Phone (818) 883-2273

Interoperability endpoints

  • Direct secure messaging: tdonaldson@exer.direct.codonix.com
  • Direct secure messaging: tina.donaldson.p1@direct.nevhc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1376934174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 SHERMAN WAY",
            "address_2": "EL PROYECTO DEL BARRIO",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062707",
            "telephone_number": "818-715-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20800 SHERMAN WAY",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062707",
            "telephone_number": "818-715-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "TINA",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "95001375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnetka, CA

Sources for this page

Verify at the official NPI Registry.