Active NPI
Patrick P Nievera
- Physical Therapist
- West Hollywood, CA
National Provider Identifier
1669738167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 37730
- Practice address
- 1016 N Orange Grove Ave
West Hollywood, CA 90046-6127 - Phone
- (626) 318-8036
- NPI assigned
- Apr 9, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 37730 | CA | Primary |
Addresses
Primary practice location
1016 N Orange Grove Ave
West Hollywood, CA 90046-6127
Mailing address
1016 N Orange Grove Ave
West Hollywood, CA 90046-6127
Phone (626) 318-8036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37730 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37730 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333929600000",
"number": "1669738167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 N ORANGE GROVE AVE",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900466127",
"telephone_number": "626-318-8036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 N ORANGE GROVE AVE",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900466127",
"telephone_number": "626-318-8036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEVERA",
"first_name": "PATRICK",
"middle_name": "P",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-09",
"last_updated": "2012-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "37730",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "37730",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.