Caroline Namirembe Mayengo, DNP, AGPNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95020746 Issued in CA

Practice address

1655 S Western Ave
Los Angeles, CA 90006-5801

Phone

(323) 737-5200

Fax

(323) 737-5400

NPI assigned

Apr 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: cmayengo2524328@oc.providencedirect.org

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.

• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  Medicare reassignment Care Compare group NPD
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tarzana Medical Center LLC

  • General Acute Care Hospital
  • Tarzana, CA
  • NPI 1821250762
  Care Compare affiliation

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1699419366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900065801",
            "telephone_number": "323-737-5200",
            "fax_number": "323-737-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900065801",
            "telephone_number": "323-737-5200",
            "fax_number": "323-737-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYENGO",
        "first_name": "CAROLINE",
        "middle_name": "NAMIREMBE",
        "credential": "DNP, AGPNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95020746",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95020746",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95020746",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy Seiji Mayeda, M.D.
• Nashwa Mayeldeen
• Thomas Mayeli
• Nelson Mayen, LMFT
• Rocio Y Mayen
• Brian James Mayer, DPT
• Emeran A Mayer, MD
• Helene Gail Mayer, OTR
• Krista Mayer
• Laura Beth Mayer, M.D.

• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.