Individual provider Active NPI

Jillianne Nanadiego, DO

  • Emergency Medicine Physician
  • Culver City, CA
National Provider Identifier
1619598133
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A22967 Issued in CA
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

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230822002498 IL Practitioner - Emergency Medicine 6406270891 Reassigns benefits to 2 organizations
I20241114003003 CA Practitioner - Emergency Medicine 6406270891 Reassigns benefits to 2 organizations

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
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

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

LicenseStateTypeSpecialty
20A22967CAMDEmergency Medicine Physician
125076015ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle West Physician Group Inc CurrentSince Aug 8, 2023 Accepting new patients
Carle Bromenn Medical Center CurrentSince Aug 8, 2023 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 11, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 18, 2025 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 11, 2024 Accepting new patients
Carle Bromenn Medical Center CurrentSince Aug 8, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 18, 2025 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

  • Direct secure messaging: jnanadiegodo384212@carlehiedirect.net
  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.