Individual provider Active NPI

David Picella, PHD, FNP, GS-C, CPG

  • Family Nurse Practitioner
  • Diamond Bar, CA
National Provider Identifier
1548426380
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP10299 Issued in CA
Practice address
836 N del Sol LN
Diamond Bar, CA 91765-1105
Phone
(877) 241-8200
Fax
(909) 245-1751
NPI assigned
Jul 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP10299 CA
Clinical Nurse Specialist 364S00000X CNS269 CA
Family Nurse Practitioner 363LF0000X NP10299 CA Primary

Addresses

Primary practice location

836 N del Sol LN
Diamond Bar, CA 91765-1105

Mailing address

340 S Lemon Ave
1295
Walnut, CA 91789-2706
Phone (877) 241-8200

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
I20091130000564 CA Practitioner - Nurse Practitioner 9133268485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7168 Archibald Ave
Suite 220
Rancho Cucamonga, CA 91701-6421
Phone (877) 241-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
NP10299CAMDFamily Nurse Practitioner
CNS269CAMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Regal Medical Group, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1548426380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S LEMON AVE",
            "address_2": "1295",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892706",
            "telephone_number": "877-241-8200",
            "fax_number": "909-245-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 N DEL SOL LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651105",
            "telephone_number": "877-241-8200",
            "fax_number": "909-245-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICELLA",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PHD, FNP, GS-C, CPG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP10299",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "CNS269",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP10299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.