Individual provider Active NPI

Monique Smallson, FNP

  • Family Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1619517455
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61502179 Issued in WA
Practice address
12 S 8TH St
Yakima, WA 98901-3020
Phone
(509) 454-4143
Fax
(509) 454-4115
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95012481 CA
Family Nurse Practitioner 363LF0000X AP61502179 WA Primary

Addresses

Primary practice location

12 S 8TH St
Yakima, WA 98901-3020

Mailing address

PO Box 2605
Yakima, WA 98907-2605
Phone (509) 454-4143

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
I20201217001688 CA Practitioner - Nurse Practitioner 9436561313 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians of Southern California IncGroup PAC ID 8123435658, 7 clinicians
Palliative Care Doctors Group, IncGroup PAC ID 6305092768, 10 clinicians

Practice addresses (Care Compare)

1304 W Holt Blvd
Suite a
Ontario, CA 91762-3640
Phone (626) 859-2249

1700 Westwood Blvd
Los Angeles, CA 90024-5608
Phone (310) 475-4865

Hospital & facility affiliations

  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61502179WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Babak Roozrokh, MD Inc CurrentSince Nov 15, 2020 Accepting new patients
Physicians of Southern California Inc CurrentSince Apr 24, 2025 Accepting new patients
Palliative Care Doctors Group, Inc CurrentSince Nov 15, 2020 Accepting new patients

Locations

1624 S Grand Ave
Glendora, CA 91740
Phone (626) 859-2249

1700 Westwood Blvd
Ste 2D
Los Angeles, CA 90024
Phone (310) 475-4865

1700 Westwood Blvd
Los Angeles, CA 90024
Phone (310) 435-1892

1304 W Holt Blvd
Ste A
Ontario, CA 91762
Phone (626) 859-2249

3235 E Colorado Blvd
Ste 102
Pasadena, CA 91107
Phone (626) 859-2249

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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 3

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": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1619517455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605",
            "telephone_number": "509-454-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S 8TH ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013020",
            "telephone_number": "509-454-4143",
            "fax_number": "509-454-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLSON",
        "first_name": "MONIQUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012481",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61502179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.