Individual provider Active NPI

Glen Ordinario, NP

  • Family Nurse Practitioner
  • Mission Hills, CA
National Provider Identifier
1639465487
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20484 Issued in CA
Practice address
11550 Indian Hills Rd
371
Mission Hills, CA 91345-1200
Phone
(818) 365-1194
Fax
(818) 898-3835
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20484 CA Primary

Addresses

Primary practice location

11550 Indian Hills Rd
371
Mission Hills, CA 91345-1200

Mailing address

11550 Indian Hills Rd
371
Mission Hills, CA 91345-1200
Phone (818) 365-1194

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
I20130201000162 CA Practitioner - Nurse Practitioner 3274787056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Consultants Medical Group IncGroup PAC ID 5597739276, 13 clinicians

Practice addresses (Care Compare)

11550 Indian Hills Rd
Suite 371
Mission Hills, CA 91345-1252
Phone (818) 365-1194

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20484CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Consultants Medical Group, Inc CurrentSince Jan 7, 2013 Accepting new patients

Locations

11550 Indian Hills Rd
Ste 371
Mission Hills, CA 91345
Phone (818) 365-1194

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: glen.ordinario@direct.davitaphysiciansolutions.com

Organizations & group practices 2

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1639465487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 INDIAN HILLS RD",
            "address_2": "371",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451200",
            "telephone_number": "818-365-1194",
            "fax_number": "818-898-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 INDIAN HILLS RD",
            "address_2": "371",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451200",
            "telephone_number": "818-365-1194",
            "fax_number": "818-898-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDINARIO",
        "first_name": "GLEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.