Individual provider Active NPI

Perla Marilyn Rodriguez, NURSE PRACTITIONER

  • Nurse Practitioner
  • Palmdale, CA
National Provider Identifier
1528580438
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95014765 Issued in CA
Practice address
38350 40TH St East
Palmdale, CA 93550
Phone
(661) 225-3050
NPI assigned
Jul 12, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95014765 CA Primary
Registered Nurse 163W00000X 849269 CA

Addresses

Primary practice location

38350 40TH St East
Palmdale, CA 93550

Mailing address

38350 40TH St E
Palmdale, CA 93552-3075
Phone (661) 225-3050

Other names 1

  • Perla Marilyn Hernandez Former name

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
I20210907001236 CA Practitioner - Nurse Practitioner 6103222757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, shared by 7 NPIs, 395 clinicians

Practice addresses (Care Compare)

335 E Ave I
Lancaster, CA 93535-1916
Phone (661) 471-4232

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
849269CAMDRegistered Nurse
95014765CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Aug 17, 2021 Accepting new patients
County of Los Angeles CurrentSince Aug 17, 2021 Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Jan 20, 2022 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1108 N Oleander Ave
Compton, CA 90222
Phone (310) 763-2244

123 W Manchester Blvd
Inglewood, CA 90301
Phone (310) 419-5325

335 E Avenue I
Lancaster, CA 93535
Phone (661) 471-4000

38350 40th St E
Palmdale, CA 93552
Phone (661) 225-3000

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

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, 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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528580438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38350 40TH ST E",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935523075",
            "telephone_number": "661-225-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38350 40TH ST EAST",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93550",
            "telephone_number": "661-225-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "PERLA",
        "middle_name": "MARILYN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2022-07-21",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95014765",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "849269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PERLA",
            "last_name": "HERNANDEZ",
            "middle_name": "MARILYN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.