Individual provider Active NPI

Reuven John Ramos

  • Psychiatric/Mental Health Nurse Practitioner
  • San Fernando, CA
National Provider Identifier
1508455296
Registry record updated Jan 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95016415 Issued in CA
Practice address
1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone
(818) 365-8086
NPI assigned
Jan 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95016415 CA Primary

Addresses

Primary practice location

1600 San Fernando Rd
San Fernando, CA 91340-3115

Mailing address

17107 Tulsa St
Granada Hills, CA 91344-4942

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
I20210420001293 CA Practitioner - Nurse Practitioner 8921416595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Northeast Valley Health CorporationGroup PAC ID 3173517323, 77 clinicians

Practice addresses (Care Compare)

12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95016415CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Valley Health Corporation CurrentSince Mar 8, 2021 Accepting new patients
Mental Wellness for Life a Nursing Corporation Psychiatric/Mental Health CurrentSince Sep 26, 2023 Accepting new patients
Northeast Valley Health Corporation Current Accepting new patients
Northeast Valley Health Corporation CurrentSince Mar 8, 2021 Accepting new patients
Brainstim Centers, Inc PastSince Jun 8, 2020 Accepting new patients

Locations

23500 Park Sorrento
Unit A4
Calabasas, CA 91302
Phone (310) 895-7122

7107 Remmet Ave
Canoga Park, CA 91303
Phone (818) 340-3570

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

12756 Van Nuys Blvd
Pacoima, CA 91331
Phone (818) 896-0531

1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

7223 Fair Ave
Sun Valley, CA 91352
Phone (818) 432-4400

28212 Kelly Johnson Pkwy
Ste 215
Valencia, CA 91355
Phone (310) 314-8250

6551 Van Nuys Blvd
Fl 2
Van Nuys, CA 91401
Phone (818) 765-8656

Interoperability endpoints

  • Direct secure messaging: johnramos.reuven.p1@direct.nevhc.nextgenshare.com

Organizations & group practices 5

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": "1610755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610755200000",
    "number": "1508455296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17107 TULSA ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403115",
            "telephone_number": "818-365-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "REUVEN JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-16",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95016415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fernando, CA

Sources for this page

Verify at the official NPI Registry.