Individual provider Active NPI

Gregorio L De Grano, NP

  • Family Nurse Practitioner
  • Northridge, CA
National Provider Identifier
1417392176
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP23058 Issued in CA
Practice address
17075 Devonshire St Ste 204
Northridge, CA 91325-5408
Phone
(661) 878-6313
NPI assigned
May 7, 2013
Last updated
May 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2013

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 NP23058 CA Primary

Addresses

Primary practice location

17075 Devonshire St Ste 204
Northridge, CA 91325-5408

Mailing address

17075 Devonshire St Ste 204
Northridge, CA 91325-5408
Phone (661) 878-6313

Other identifiers 1

IdentifierTypeStateIssuer
23058OtherCANP

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
I20130611000838 CA Practitioner - Nurse Practitioner 6507005121 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
California Wound and Hyperbaric Specialists IncGroup PAC ID 4880195627, 5 clinicians

Practice addresses (Care Compare)

Pleasant Hill, CA 94523
Phone (510) 224-6556

19715 Sherman Way
Suite 390
Winnetka, CA 91306-3601
Phone (818) 572-0789

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
California Wound & Hyperbaric Specialists Inc CurrentSince Aug 15, 2025 Accepting new patients
Intel Medical Group Inc CurrentSince Dec 1, 2021 Accepting new patients
Luis M Blando MD Inc CurrentSince Dec 1, 2021 Accepting new patients
Kindred Heart Hospice, Inc PastSince Apr 8, 2019 Accepting new patients

Locations

10727 White Oak Ave
Ste 117
Granada Hills, CA 91344
Phone (818) 224-9390

2255 Morello Ave
Ste 121
Pleasant Hill, CA 94523
Phone (510) 224-6556

430 Park Ave
Port Hueneme, CA 93041
Phone (805) 487-3881

19715 Sherman Way
Ste 390
Winnetka, CA 91306
Phone (818) 572-0789

20301 Ventura Blvd
Ste 352
Woodland Hills, CA 91364
Phone (818) 593-9140

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1417392176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255408",
            "telephone_number": "661-878-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255408",
            "telephone_number": "661-878-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GRANO",
        "first_name": "GREGORIO",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP23058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP",
            "identifier": "23058",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.