Active NPI
Tia Ibrahim Andrawis, DNP
- Nurse Practitioner
- Universal City, CA
National Provider Identifier
1467211664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95027945
- Practice address
- 100 Universal City PLZ
Universal City, CA 91608-1002 - Phone
- (323) 789-5610
- NPI assigned
- Mar 18, 2024
- Last updated
- Mar 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95027945 | CA | Primary |
Addresses
Primary practice location
100 Universal City PLZ
Universal City, CA 91608-1002
Mailing address
300 45TH St S
Fargo, ND 58103-1189
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240911000706 | CA | Order and Referring Only - Nurse Practitioner | 2466992938 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1467211664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 45TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581031189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 UNIVERSAL CITY PLZ",
"city": "UNIVERSAL CITY",
"state": "CA",
"postal_code": "916081002",
"telephone_number": "323-789-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRAWIS",
"first_name": "TIA",
"middle_name": "IBRAHIM",
"name_prefix": "Dr.",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95027945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Universal City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.