Jerrick Ky Xang Padilla-Phu, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95012638 Issued in CA

Practice address

1510 S Central Ave Ste 240
Glendale, CA 91204-2570

Phone

(818) 334-5425

NPI assigned

Jun 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Oncology Institute Ca, a Professional CorporationGroup PAC ID 5698872398, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jerrick.padilla-phu@theoncologyinstitute.ikm.direct-ci.com

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.

• The Oncology Institute Ca, a Professional Corporation

  • Hematology & Oncology Physician
  • Downey, CA
  • NPI 1275651515
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System - Southern California

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  Care Compare affiliation

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1457976938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 PUEBLO DR",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917704346",
            "telephone_number": "626-688-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE STE 240",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042570",
            "telephone_number": "818-334-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA-PHU",
        "first_name": "JERRICK",
        "middle_name": "KY XANG",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "849559",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95012638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Medical Pharmacy Inc
• Pacific Multi Specialty Medical Group, Inc.
• Pacific Park Healthcare Center LLC
• Pacific Shores Medical Group, Inc.
• Pacific West Wellness Center Beltran Chiropractic Inc
• Ashley Padilla
• Pia Bravo Padillo
• Daniel Padron
• Mark E Page, DDS
• Pilar Paguia

• Family Nurse Practitioner in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.