Individual provider Active NPI

Nalinee Mathitak

  • Gerontology Nurse Practitioner
  • Trabuco Canyon, CA
National Provider Identifier
1396104741
Registry record updated Feb 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP95003807 Issued in CA
Practice address
39 Muirfield
Trabuco Canyon, CA 92679-3421
Phone
(714) 220-7399
NPI assigned
Feb 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 807685 CA
Gerontology Nurse Practitioner 363LG0600X NP95003807 CA Primary

Addresses

Primary practice location

39 Muirfield
Trabuco Canyon, CA 92679-3421

Mailing address

39 Muirfield
Trabuco Canyon, CA 92679-3421

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
I20160411000406 CA Practitioner - Nurse Practitioner 8820396757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Linda Hsu a Professional CorporationGroup PAC ID 9931101318, 2 clinicians

Practice addresses (Care Compare)

11101 La Reina Ave
Suite 101
Downey, CA 90241-4237
Phone (562) 867-2796

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
807685CAMDRegistered Nurse
NP95003807CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Linda Hsu a Professional Corporation CurrentSince Mar 15, 2016 Accepting new patients

Locations

16910 Woodruff Ave
Bellflower, CA 90706
Phone (562) 867-1761

11101 La Reina Ave
#101
Downey, CA 90241
Phone (562) 867-2796

Organizations & group practices 2

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": "1455408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455408000000",
    "number": "1396104741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MUIRFIELD",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926793421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 MUIRFIELD",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926793421",
            "telephone_number": "714-220-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHITAK",
        "first_name": "NALINEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-14",
        "last_updated": "2016-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "807685",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP95003807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trabuco Canyon, CA

Sources for this page

Verify at the official NPI Registry.