Mario Pacheco, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95000401 Issued in CA

Practice address

11012 Loch Avon Dr
Whittier, CA 90606-1530

Phone

(562) 774-5351

NPI assigned

Feb 26, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oceanside Medical Group a Medical CorporationGroup PAC ID 9335311042, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• L a Downtown Medical Center Hospital, Los Angeles, CA, CCN 050763
• Los Angeles Community Hospital Hospital, Los Angeles, CA, CCN 050663
• Huntington Beach Hospital Hospital, Huntington Beach, CA, CCN 050526
• Garden Grove Hospital & Medical Center Hospital, Garden Grove, CA, CCN 050230
• West Anaheim Medical Center Hospital, Anaheim, CA, CCN 050426

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Oceanside Medical Group, a Medical Corporation

  • Psychiatry Physician
  • Santa Monica, CA
  • NPI 1861770513
  Medicare reassignment Care Compare group

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

• Alta Los Angeles Hospital, Inc

  • Skilled Nursing Facility
  • Los Angeles, CA
  • NPI 1114132685

  Hospital

  Care Compare affiliation
• Alta Los Angeles Hospitals, Inc.

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922001809
  Care Compare affiliation
• L. a. Downtown Medical Center, LLC.

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1780183335
  Care Compare affiliation
• L. a. Downtown Medical Center, LLC.

  • Rehabilitation Hospital Unit
  • Los Angeles, CA
  • NPI 1982351565
  Care Compare affiliation
• Prime Healthcare Anaheim, LLC

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1871501916
  Care Compare affiliation
• Prime Healthcare Huntington Beach, LLC

  • General Acute Care Hospital
  • Huntington Beach, CA
  • NPI 1083622120
  Care Compare affiliation
• Prime Healthcare Services - Garden Grove LLC

  • General Acute Care Hospital
  • Garden Grove, CA
  • NPI 1659538858
  Care Compare affiliation

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1568887669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 LOCH AVON DR",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906061530",
            "telephone_number": "562-774-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 LOCH AVON DR",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906061530",
            "telephone_number": "562-774-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-26",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "570465",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95000401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Adanna Otuwa, MD
• Zareh John Ounjian, MD
• Dakiesha Denise Owens
• Emilia Pacheco
• Irene Ariel Pacheco
• Pacific Anesthesia Consultants, a Medical Corporation
• Pacific Clinics
• Ammie Padilla
• Destiny Padilla
• Saylia Padilla

• Psychiatric/Mental Health Nurse Practitioner in Whittier, CA
• Providers in Whittier, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.