Individual provider Active NPI

Miki K. Tortorelli, N.P.-C

  • Family Nurse Practitioner
  • Fountain Valley, CA
National Provider Identifier
1750772000
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95001943 Issued in CA
Practice address
16055 Brookhurst St Ste C
Fountain Valley, CA 92708-1566
Phone
(714) 839-2400
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 745193 CA
Family Nurse Practitioner 363LF0000X NPF95001943 CA
Family Nurse Practitioner 363LF0000X NP95001943 CA Primary

Addresses

Primary practice location

16055 Brookhurst St Ste C
Fountain Valley, CA 92708-1566

Mailing address

16055 Brookhurst St Ste C
Fountain Valley, CA 92708-1566
Phone (714) 839-2400

Other practice location 1

2777 Pacific Ave
Long Beach, CA 90806-2625
Phone (562) 426-6571

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
I20160415001487 CA Practitioner - Nurse Practitioner 1557671377 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
745193CAMDRegistered Nurse
NP95001943CAMDFamily Nurse Practitioner
NPF95001943CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phong H Bui Inc CurrentSince Oct 1, 2017 Accepting new patients
Orange Coast Memorial Medical Center PastSince Oct 1, 2017 Accepting new patients

Locations

16055 Brookhurst St
Ste C
Fountain Valley, CA 92708
Phone (714) 839-2400

15606 Brookhurst St
Ste B
Westminster, CA 92683
Phone (714) 531-0000

Organizations & group practices 2

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": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1750772000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 BROOKHURST ST STE C",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081566",
            "telephone_number": "714-839-2400",
            "fax_number": "714-839-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 BROOKHURST ST STE C",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081566",
            "telephone_number": "714-839-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2777 Pacific Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908062625",
            "country_code": "US",
            "telephone_number": "562-426-6571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORTORELLI",
        "first_name": "MIKI",
        "middle_name": "K.",
        "credential": "N.P.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "745193",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NPF95001943",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95001943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.