Individual provider Active NPI

Kateryna Moskalenko, FNP

  • Family Nurse Practitioner
  • Tarzana, CA
National Provider Identifier
1487481289
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95191775 Issued in CA
Practice address
19634 Ventura Blvd Ste 219
Tarzana, CA 91356-7139
Phone
(818) 469-4194
NPI assigned
Sep 16, 2024
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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 95191775 CA Primary

Addresses

Primary practice location

19634 Ventura Blvd Ste 219
Tarzana, CA 91356-7139

Mailing address

19634 Ventura Blvd Ste 219
Tarzana, CA 91356-7139
Phone (818) 469-4194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95191775CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Astral Hospice and Palliative Care, Inc Current Accepting new patients
Centinela Hospice Care, Inc. CurrentSince Sep 23, 2024 Accepting new patients

Locations

19634 Ventura Blvd
Ste 219
Tarzana, CA 91356
Phone (818) 469-4194

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": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1487481289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19634 VENTURA BLVD STE 219",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913567139",
            "telephone_number": "818-469-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19634 VENTURA BLVD STE 219",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913567139",
            "telephone_number": "818-469-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKALENKO",
        "first_name": "KATERYNA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95191775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.