Individual provider Active NPI

Oksana Mazurova, FNP

  • Family Nurse Practitioner
  • North Hollywood, CA
National Provider Identifier
1699487090
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023317 Issued in CA
Practice address
11631 Victory Blvd Ste 101
North Hollywood, CA 91606-3572
Phone
(818) 764-8838
NPI assigned
Dec 16, 2022
Last updated
Dec 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95023317 CA Primary
General Practice Registered Nurse 163WG0000X 95062071 CA

Addresses

Primary practice location

11631 Victory Blvd Ste 101
North Hollywood, CA 91606-3572

Mailing address

7135 Hollywood Blvd Apt 410
West Hollywood, CA 90046-3543
Phone (818) 939-6307

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
I20260616000975 CA Practitioner - Nurse Practitioner 0749752285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1101 E Broadway
Suite 103
Glendale, CA 91205-1383

26235 Ravenhill Rd
Santa Clarita, CA 91387-4046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95062071CAMDGeneral Practice Registered Nurse
95023317CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Loren Chen, MD Inc CurrentSince Dec 1, 2024 Accepting new patients
Choice Providers Medical Group Inc PastSince Dec 18, 2022 Accepting new patients

Locations

11631 Victory Blvd
Ste 101
North Hollywood, CA 91606
Phone (818) 509-3587

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1699487090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7135 HOLLYWOOD BLVD APT 410",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900463543",
            "telephone_number": "818-939-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11631 VICTORY BLVD STE 101",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063572",
            "telephone_number": "818-764-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUROVA",
        "first_name": "OKSANA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023317",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95062071",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.