Individual provider Active NPI

Irish Shane Tapiceria

  • Gerontology Nurse Practitioner
  • Bellflower, CA
National Provider Identifier
1417844127
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95030930 Issued in CA
Practice address
10322 Park St
Bellflower, CA 90706-6029
Phone
(310) 606-0998
NPI assigned
Jun 24, 2025
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95030930 CA Primary

Addresses

Primary practice location

10322 Park St
Bellflower, CA 90706-6029

Mailing address

10322 Park St
Bellflower, CA 90706-6029

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
I20251212000427 CA Practitioner - Nurse Practitioner 4587158936 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor Wound Care P CGroup PAC ID 0042704504, 29 clinicians
Alpha Wound Solutions PCGroup PAC ID 3375037443, 6 clinicians

Practice addresses (Care Compare)

Irvine, CA 92618
Phone (877) 414-7739

1424 Hummingbird Way
Banning, CA 92220-7206
Phone (626) 250-4912

275 W Hospitality LN
Suite 310
San Bernardino, CA 92408-3265
Phone (951) 229-8408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95030930CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Wound Care P.C. CurrentSince Nov 19, 2025 Accepting new patients
Anousheh Ashouri MD Inc CurrentSince Nov 24, 2025 Accepting new patients
Alpha Wound Solutions P.C. CurrentSince Dec 21, 2025 Accepting new patients

Locations

275 W Hospitality Ln
Ste 310
San Bernardino, CA 92408
Phone (951) 229-8408

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, 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": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1417844127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10322 PARK ST",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907066029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10322 PARK ST",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907066029",
            "telephone_number": "310-606-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPICERIA",
        "first_name": "IRISH SHANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95030930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

Verify at the official NPI Registry.