Active NPI
Roselou R Perun, NP
- Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1780958330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 21190
- Practice address
- 1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315 - Phone
- (323) 442-8545
- NPI assigned
- Feb 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 21190 | CA | Primary |
Addresses
Primary practice location
1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315
Mailing address
127 Pamela Rd
Monrovia, CA 91016-5034
Phone (323) 708-9198
Other practice location 1
1520 San Pablo St
Suite 1000
Los Angeles, CA 90033-5310
Phone (323) 442-5100
Other practice location 2
1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8545
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902846306 | Other | CA | GROUP NPI |
| GR0100430 | Other | CA | GROUP MEDI-CAL |
| W18762 | Other | CA | GROUP MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | roselou.rabara@direct.usc.edu | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21190 | CA | MD | Marriage & Family Therapist |
Interoperability endpoints
- roselou.rabara@direct.usc.edu
- rperun1181046@direct.uclahealth.org
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.
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1780958330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 PAMELA RD",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910165034",
"telephone_number": "323-708-9198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SAN PABLO ST STE 3000",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335315",
"telephone_number": "323-442-8545"
}
],
"practiceLocations": [
{
"address_1": "1520 San Pablo St",
"address_2": "Suite 1000",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900335310",
"country_code": "US",
"telephone_number": "323-442-5100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 San Pablo St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900335313",
"country_code": "US",
"telephone_number": "323-442-8545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERUN",
"first_name": "ROSELOU",
"middle_name": "R",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-29",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "21190",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1902846306",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDI-CAL",
"identifier": "GR0100430",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE",
"identifier": "W18762",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "roselou.rabara@direct.usc.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1520 San Pablo St Ste 3000",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900335315",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.