Individual provider Active NPI

Casey Lyn Mosard, FNP

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1457839748
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95006416 Issued in CA
Practice address
1045 Atlantic Ave Ste 611
Long Beach, CA 90813-3414
Phone
(562) 432-0111
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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 NP95006416 CA Primary

Addresses

Primary practice location

1045 Atlantic Ave Ste 611
Long Beach, CA 90813-3414

Mailing address

6331 Pacific Way
Westminster, CA 92683-8529
Phone (714) 856-5836

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
I20190114001180 CA Practitioner - Nurse Practitioner 6002152931 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95006416CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Innovation and Research Center Inc CurrentSince Sep 26, 2018 Accepting new patients

Locations

1045 Atlantic Ave
Ste 611
Long Beach, CA 90813
Phone (562) 432-0111

Organizations & group practices 1

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1457839748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 PACIFIC WAY",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926838529",
            "telephone_number": "714-856-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE STE 611",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133414",
            "telephone_number": "562-432-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSARD",
        "first_name": "CASEY",
        "middle_name": "LYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95006416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.