Individual provider Active NPI

Tristie Yumul

  • Certified Registered Nurse Anesthetist
  • Chatsworth, CA
National Provider Identifier
1497000822
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4284 Issued in CA
Practice address
20645 Septo St
Chatsworth, CA 91311-4504
Phone
(818) 438-8777
NPI assigned
Jul 23, 2012
Last updated
Nov 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4284 CA Primary

Addresses

Primary practice location

20645 Septo St
Chatsworth, CA 91311-4504

Mailing address

20645 Septo St
Chatsworth, CA 91311-4504
Phone (818) 438-8777

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130111000369 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507019080 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Monica Medical Institute IncGroup PAC ID 4789663048, 8 clinicians

Practice addresses (Care Compare)

1908 Santa Monica Blvd
Suite 3
Santa Monica, CA 90404-1927
Phone (310) 829-5475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4284CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Anesthesia Specialists a Medical Corporation CurrentSince Apr 26, 2023 Accepting new patients
Reekeshrpatelmd Inc CurrentSince Mar 7, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 26, 2012 Accepting new patients
Santa Monica Medical Institute Inc CurrentSince Aug 7, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Advanced Anesthesia Specialists a Medical Corporation CurrentSince Apr 26, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 26, 2012 Accepting new patients
Sky Anesthesia Inc. CurrentSince Oct 8, 2019 Accepting new patients

Locations

4477 W 118th St
Ste 501
Hawthorne, CA 90250
Phone (310) 679-9999

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

1908 Santa Monica Blvd
Ste 3
Santa Monica, CA 90404
Phone (310) 582-9191

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

7230 Medical Ctr
Ste 500
West Hills, CA 91307
Phone (310) 285-2424

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Organizations & group practices 9

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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1497000822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20645 SEPTO ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913114504",
            "telephone_number": "818-438-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20645 SEPTO ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913114504",
            "telephone_number": "818-438-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUMUL",
        "first_name": "TRISTIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "4284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chatsworth, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.