Active NPI
Jillianne Nanadiego, DO
- Emergency Medicine Physician
- Culver City, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20A22967
- Practice address
- 10100 Culver Blvd Ste E
Culver City, CA 90232-3174 - Phone
- (310) 423-3333
- NPI assigned
- May 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 125076015 | IL | |
| Emergency Medicine Physician | 207P00000X | 20A22967 | CA | Primary |
Addresses
Primary practice location
10100 Culver Blvd Ste E
Culver City, CA 90232-3174
Mailing address
4140 W 190TH St
Torrance, CA 90504-5513
Other practice location 1
1304 Franklin Ave
Normal, IL 61761-3558
Phone (309) 268-5130
Other practice location 2
701 N 1st St Ste D220
Springfield, IL 62702-3757
Phone (217) 545-3518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Rocky Vista University College of Osteopathic Med, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10100 Culver Blvd
Suite E
Culver City, CA 90232-3174
Phone (310) 423-3333
6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A22967 | CA | MD | Emergency Medicine Physician |
| 125076015 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle West Physician Group Inc | Current | Accepting new patients | |
| Carle Bromenn Medical Center | Current | Accepting new patients | |
| Cedars-Sinai Medical Care Foundation | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Cedars-Sinai Medical Care Foundation | Current | Accepting new patients | |
| Carle Bromenn Medical Center | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Carle Health Care Incorporated | Past | Accepting new patients |
Locations
8767 Wilshire Blvd
#2
Beverly Hills, CA 90211
8767 Wilshire Blvd
Fl 2
Beverly Hills, CA 90211
Phone (310) 248-7000
10100 Culver Blvd
Ste E
Culver City, CA 90232
Phone (310) 423-3333
10100 Culver Blvd
Culver City, CA 90232
Phone (310) 280-2700
8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674
1922 Hillhurst Ave
Fl 2
Los Angeles, CA 90027
Phone (310) 423-6185
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
12746 W Jefferson Blvd
Ste 2000
Playa Vista, CA 90094
Phone (424) 315-2220
4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
1304 Franklin Ave
Ste 380
Normal, IL 61761
Phone (309) 268-3598
1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590
1300 Franklin Ave
Ste 100
Normal, IL 61761
Phone (309) 268-3503
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- jnanadiegodo384212@carlehiedirect.net
- jnanadiego513529@direct.cshs.org
Organizations & group practices 9
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.
-
- Specialist
- Los Angeles, CA
- NPI 1316984388
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
dba Bromenn Family Health Clinic
- Clinic/Center
- Normal, IL
- NPI 1104442615
-
- Family Medicine Physician
- Normal, IL
- NPI 1467074138
-
- Anesthesiology Physician
- Los Angeles, CA
- NPI 1043826720
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Inglewood, CA
- NPI 1821635079
-
dba Advocate BroMenn Medical Center
- General Acute Care Hospital
- Normal, IL
- NPI 1962424036
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1639172372
-
- General Acute Care Hospital
- West Hollywood, CA
- NPI 1891940326
-
dba Kaiser Foundation Hospital West Los Angeles
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1134274897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1619598133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 W 190TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905045513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10100 CULVER BLVD STE E",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902323174",
"telephone_number": "310-423-3333"
}
],
"practiceLocations": [
{
"address_1": "1304 Franklin Ave",
"address_purpose": "LOCATION",
"city": "Normal",
"state": "IL",
"postal_code": "617613558",
"country_code": "US",
"telephone_number": "309-268-5130",
"fax_number": "309-268-5784",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "701 N 1st St Ste D220",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "IL",
"postal_code": "627023757",
"country_code": "US",
"telephone_number": "217-545-3518",
"fax_number": "217-545-2711",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NANADIEGO",
"first_name": "JILLIANNE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-06",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125076015",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "20A22967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.