NPIMap

Individual provider Active NPI

Oriel Ashley Renault Nissim

  • Obstetrics & Gynecology Physician
  • Glendora, CA
National Provider Identifier
1447606694
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A177711 Issued in CA
Practice address
415 W Carroll Ave FL 1
Glendora, CA 91741-4208
Phone
(626) 963-4124
NPI assigned
May 6, 2016
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A177711 CA Primary

Addresses

Primary practice location

415 W Carroll Ave FL 1
Glendora, CA 91741-4208

Mailing address

1041 W Badillo St Ste 104
Covina, CA 91722-4194
Phone (626) 732-8319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805001422 CA Practitioner - Obstetrics/Gynecology 3971881293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emanate Health Medical Care FoundationGroup PAC ID 9830544980, 85 clinicians

Practice addresses (Care Compare)

315 E Route 66
Glendora, CA 91740-6244
Phone (626) 963-4124

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.36 of 100Reported as group
Quality
60.04
Promoting interoperability
87
Improvement activities
40
Cost
69.31

Merit-based Incentive Payment System (MIPS)

Final score
82.35 of 100Reported as group
Quality
52.92
Promoting interoperability
93
Improvement activities
40
Cost
70.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Valley Physician Partners CurrentSince Aug 1, 2022 Accepting new patients
Emanate Health Medical Group Current Accepting new patients
Emanate Health Medical Group Obstetrics & Gynecology CurrentSince Aug 1, 2022 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

14375 Pipeline Ave
Chino, CA 91710
Phone (626) 918-6544

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

315 E Route 66
Glendora, CA 91740
Phone 6269634121211

315 E Route 66
Ste 109
Glendora, CA 91740

412 W Carroll Ave
Ste 108
Glendora, CA 91741
Phone (626) 852-0411

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

1135 S Sunset Ave
Ste 401
West Covina, CA 91790
Phone (626) 732-8390

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1447606694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 W BADILLO ST STE 104",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917224194",
            "telephone_number": "626-732-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W CARROLL AVE FL 1",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414208",
            "telephone_number": "626-963-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSIM",
        "first_name": "ORIEL",
        "middle_name": "ASHLEY RENAULT",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A177711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.