Providence Medical Institute

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROVIDENCE MEDICAL INSTITUTE

Doing business as

Providence Little Company of Mary Medical Institute

Practice address

4101 Torrance Blvd
Torrance, CA 90503-4607

Phone

(310) 793-8075

Fax

(310) 793-8195

NPI assigned

Jun 14, 2006

Last updated

May 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donald Wayne Anderson Jr.

Title

Assistant Secretary of Enrollments

Phone

(425) 358-9786

Specialties & licenses 10

Addresses

Other names 1

• Providence Little Company of Mary Medical Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in CA, WA, OR, AK, IL, CO, FL, MI, MT, NC, NV, TN, HI, TX, NY, GA, DC, ID, AZ, WI, NE, UT, PA23 enrollments

Enrollment records 23

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760

  5991609737

  Same PAC ID

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569

  O20031121000910, O20200507001918

  Same enrollment
• Providence Medical Institute

  dba Providence Little Company of Mary

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356394175

  O20031121000910

  Same enrollment
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1376594671

  O20031121000910

  Same enrollment
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760

  O20031121000910

  Same enrollment
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1972546091

  O20031121000910

  Same enrollment

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Pacific Endo-Surgical Center LP

  • Ambulatory Surgical Clinic/Center
  • Torrance, CA
  • NPI 1588867030

  Member Of

  NPD member

Locations

Practitioners 272

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Babak Akbarian, M.D.

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1255740817
  Medicare reassignment Care Compare group NPD
• Nabil Al-Kourainy, MD

  • Infectious Disease Physician
  • Portland, OR
  • NPI 1902339971

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Taylor R Anderson, MD

  • Neurology Physician
  • Muskegon, MI
  • NPI 1255992806
  Medicare reassignment Care Compare group NPD
• Benjamin Edward Atkinson, M.D.

  • Neurology Physician
  • Spokane, WA
  • NPI 1023256237
  Medicare reassignment Care Compare group NPD
• Sarabjit Kaur Atwal, MD

  • Vascular Neurology Physician
  • Richland, WA
  • NPI 1881928414
  Medicare reassignment Care Compare group NPD
• Preethi Balakrishnan, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Seattle, WA
  • NPI 1447578927
  Medicare reassignment Care Compare group NPD
• Leah Marie Basnett, MD

  • Psychiatry Physician
  • Edmonds, WA
  • NPI 1235246091
  Medicare reassignment Care Compare group NPD
• Abdelrahman Fouad Ahmed Beltagy, M.D.

  • Neurology Physician
  • Spokane, WA
  • NPI 1013250216

  TX

  Medicare reassignment Care Compare group NPD
• William R Berrington III, M.D., PH.D.

  • Infectious Disease Physician
  • Seattle, WA
  • NPI 1558374025
  Medicare reassignment Care Compare group NPD
• Pratik Dipakeshwar Bhattacharya, MD MPH

  • Neurology Physician
  • Pontiac, MI
  • NPI 1528212768
  Medicare reassignment Care Compare group NPD
• Eric Chien-Yeh Chang, MD

  • Infectious Disease Physician
  • Portland, OR
  • NPI 1720290190

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Michael Meng Chen, MD, MS

  • Vascular Neurology Physician
  • Seattle, WA
  • NPI 1558757757
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1760425862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-3029",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911103029",
            "telephone_number": "310-792-4015",
            "fax_number": "310-792-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TORRANCE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034607",
            "telephone_number": "310-793-8075",
            "fax_number": "310-793-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE MEDICAL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Little Company of Mary Medical Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Little Company of Mary Medical Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Medical Institute (Providence Little Company of Mary Medical Institute)
• Providence Medical Institute (Providence Little Company of Mary)
• Providence Medical Institute
• Providence Medical Institute (Providence Little Company of Mary Medical Institute)
• Providence Medical Institute
• Providence Medical Institute (Providence Little Company of Mary Medical Institute)
• Providence Trinitycare Hospice
• Providence Trinitycare Hospice
• Jordyn Pruitt
• Abigail G Prushansky, FNP-BC, CNM

• Family Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.