Individual provider Active NPI

Joseph K Muriithi, ACNPC-AG

  • Pediatric Registered Nurse
  • Baldwin Park, CA
National Provider Identifier
1710415559
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
95321194 Issued in CA
Practice address
13264 Ramona Blvd Unit C
Baldwin Park, CA 91706-3882
Phone
(405) 535-1105
NPI assigned
May 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95026854 CA
Acute Care Nurse Practitioner 363LA2100X 71007277A IN
Pediatric Registered Nurse 163WP0200X 95321194 CA Primary

Addresses

Primary practice location

13264 Ramona Blvd Unit C
Baldwin Park, CA 91706-3882

Mailing address

13264 Ramona Blvd Unit C
Baldwin Park, CA 91706-3882
Phone (405) 535-1105

Other identifiers 2

IdentifierTypeStateIssuer
300007827MedicaidIN
000001098390OtherINANTHEM

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
I20240710002295 CA Practitioner - Nurse Practitioner 9739450164 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark H Mazur MD & Barry Statner MD a Professional Corporation CurrentSince Apr 27, 2024 Accepting new patients

Locations

2360 E Bidwell St
Ste 107
Folsom, CA 95630
Phone (916) 220-2951

4980 Barranca Pkwy
Ste 195
Irvine, CA 92604
Phone (949) 398-5280

1174 Castro St
Ste 150
Mountain View, CA 94040

24640 Jefferson Ave
Ste 208
Murrieta, CA 92562
Phone (951) 395-5457

301 S Fair Oaks Ave
Ste 304
Pasadena, CA 91105
Phone (626) 960-2711

15706 Pomerado Rd
Ste S202
Poway, CA 92064

2220 Lynn Rd
Ste 301
Thousand Oaks, CA 91360
Phone (805) 495-1073

130 La Casa Via
Ste 108
Walnut Creek, CA 94598

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

Organizations & group practices 1

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1710415559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13264 RAMONA BLVD UNIT C",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063882",
            "telephone_number": "405-535-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13264 RAMONA BLVD UNIT C",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063882",
            "telephone_number": "405-535-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURIITHI",
        "first_name": "JOSEPH",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95026854",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71007277A",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "95321194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007827",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001098390",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, CA

Sources for this page

Verify at the official NPI Registry.