Individual provider Active NPI

Olga Verkhovsky, NP

  • Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1629099874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
540274 Issued in CA
Practice address
2650 Elm Ave
Ste 218
Long Beach, CA 90806-1651
Phone
(818) 705-1239
Fax
(818) 705-0448
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 540274 CA Primary

Addresses

Primary practice location

2650 Elm Ave
Ste 218
Long Beach, CA 90806-1651

Mailing address

PO Box 91989
Long Beach, CA 90809-1989
Phone (818) 705-1239

Other identifiers 1

IdentifierTypeStateIssuer
540274OtherCASTATE LCIENSE

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
I20110609000658 CA Practitioner - Nurse Practitioner 2264619758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Pain Care Medical Centers IncGroup PAC ID 1052456019, 2 clinicians

Practice addresses (Care Compare)

2650 Elm Ave
Suite 218
Long Beach, CA 90806-1653
Phone (562) 485-5020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
540274CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Care Medical Centers Inc. CurrentSince Feb 26, 2011 Accepting new patients

Locations

2650 Elm Ave
Ste 218
Long Beach, CA 90806
Phone (562) 424-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629099874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91989",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908091989",
            "telephone_number": "818-705-1239",
            "fax_number": "818-705-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 ELM AVE",
            "address_2": "STE 218",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061651",
            "telephone_number": "818-705-1239",
            "fax_number": "818-705-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERKHOVSKY",
        "first_name": "OLGA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "540274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LCIENSE",
            "identifier": "540274",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.