Individual provider Active NPI

Carey W. Mahoney, N.P.

  • Family Nurse Practitioner
  • Northridge, CA
National Provider Identifier
1790082139
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19797 Issued in CA
Practice address
18460 Roscoe Blvd
Northridge, CA 91325-4107
Phone
(818) 734-3600
NPI assigned
Feb 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19797 CA Primary

Addresses

Primary practice location

18460 Roscoe Blvd
Northridge, CA 91325-4107

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559

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
I20131113002132 CA Practitioner - Nurse Practitioner 7719125970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19797CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince May 8, 2015 Accepting new patients
Providence Facey Medical Foundation CurrentSince May 8, 2015 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Paulding Medical Center, Inc. Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

11333 Sepulveda Blvd
Fl 2
Mission Hills, CA 91345
Phone (818) 869-7263

11333 Sepulveda Blvd
Mission Hills, CA 91345
Phone (818) 365-9531

9111 Corbin Ave
Northridge, CA 91324
Phone (818) 743-5700

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

9111 Corbin Ave
Fl 1
Northridge, CA 91324

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Interoperability endpoints

  • Direct secure messaging: cmahoney447781@oc.providencedirect.org

Organizations & group practices 4

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": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1790082139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18460 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107",
            "telephone_number": "818-734-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "CAREY",
        "middle_name": "W.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-22",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.