Individual provider Active NPI

Lesly Ghiglino Duetsch, NP

  • Acute Care Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1750844759
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95009294 Issued in CA
Practice address
1509 Wilson Ter
Glendale, CA 91206-4007
Phone
(818) 409-8421
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95009294 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206-4007

Mailing address

23367 Friar St
Woodland Hills, CA 91367-1432
Phone (818) 300-2589

Other practice location 1

15107 Vanowen St
Van Nuys, CA 91405-4542
Phone (818) 300-2589

Other practice location 2

15107 Vanowen St
Van Nuys, CA 91405-4542
Phone (818) 300-2589

Other practice location 3

15107 Vanowen St
Van Nuys, CA 91405-4542
Phone (818) 300-2589

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
I20190611001925 CA Practitioner - Nurse Practitioner 1254664071 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians, PC Current Accepting new patients
Galen Inpatient Physicians PC CurrentSince Oct 11, 2021 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Oct 11, 2021 Accepting new patients
San Fernando Valley Medical Group Inc CurrentSince Mar 2, 2020 Accepting new patients

Locations

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4955 Van Nuys Blvd
Ste 502
Sherman Oaks, CA 91403
Phone (818) 325-0200

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

Organizations & group practices 5

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1750844759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23367 FRIAR ST",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913671432",
            "telephone_number": "818-300-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15107 Vanowen St",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914054542",
            "country_code": "US",
            "telephone_number": "818-300-2589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15107 Vanowen St",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914054542",
            "country_code": "US",
            "telephone_number": "818-300-2589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15107 Vanowen St",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914054542",
            "country_code": "US",
            "telephone_number": "818-300-2589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHIGLINO DUETSCH",
        "first_name": "LESLY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95009294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.