Individual provider Active NPI

Mukul Aeri, FNP-C

  • Nurse Practitioner
  • South Gate, CA
National Provider Identifier
1679319289
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95030825 Issued in CA
Practice address
4476 Tweedy Blvd Ste B
South Gate, CA 90280-6359
Phone
(323) 268-9191
NPI assigned
Jul 2, 2024
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95030825 CA Primary
Family Medicine Physician 207Q00000X 95030825 CA

Addresses

Primary practice location

4476 Tweedy Blvd Ste B
South Gate, CA 90280-6359

Mailing address

18808 Fagan Ave
Artesia, CA 90701-5803
Phone (657) 337-1123

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
I20251223002921 CA Practitioner - Nurse Practitioner 0749775054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3601 E 1St St
Los Angeles, CA 90063-2325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95030825CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Via Care Community Health Center CurrentSince Oct 11, 2025 Accepting new patients
Via Care Community Health Center Multi-Specialty CurrentSince Oct 11, 2025 Accepting new patients

Locations

501 S Atlantic Blvd
Los Angeles, CA 90022
Phone (323) 268-5442

507 S Atlantic Blvd
Los Angeles, CA 90022
Phone 32326891911067

4476 Tweedy Blvd
Ste B
South Gate, CA 90280
Phone (323) 825-8300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1679319289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18808 FAGAN AVE",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907015803",
            "telephone_number": "657-337-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 TWEEDY BLVD STE B",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806359",
            "telephone_number": "323-268-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AERI",
        "first_name": "MUKUL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-02",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95030825",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95030825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.