Individual provider Active NPI

Masoud Nadi, FNP-C

  • Family Nurse Practitioner
  • La Mesa, CA
National Provider Identifier
1396259172
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007635 Issued in CA
Practice address
4535 70TH St
La Mesa, CA 91942-0701
Phone
(619) 609-9294
Fax
(619) 720-2112
NPI assigned
Dec 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95007635 CA Primary

Addresses

Primary practice location

4535 70TH St
La Mesa, CA 91942-0701

Mailing address

4535 70TH St
La Mesa, CA 91942-0701
Phone (619) 609-9294

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
I20230217001867 CA Practitioner - Nurse Practitioner 8527430669 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95007635CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Point Health Care Services, Inc. Past Accepting new patients
Planned Parenthood of the Pacific Southwest Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1396259172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 70TH ST",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420701",
            "telephone_number": "619-609-9294",
            "fax_number": "619-720-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 70TH ST",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420701",
            "telephone_number": "619-609-9294",
            "fax_number": "619-720-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADI",
        "first_name": "MASOUD",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-01",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.