Ronald Shistick, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19641 Issued in CA

Practice address

7847 Valley Flores Dr
West Hills, CA 91304-6105

Phone

(818) 992-1502

NPI assigned

Oct 5, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ronald.shistick.p1@direct.lakeside.nextgenshare.com

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.

• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment NPD

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1790094928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7847 VALLEY FLORES DR",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913046105",
            "telephone_number": "818-992-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7847 VALLEY FLORES DR",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913046105",
            "telephone_number": "818-992-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHISTICK",
        "first_name": "RONALD",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-05",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4444167333",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew David Sheridan, MD
• Sherif Said MD PC
• Shervin Aminpour MD PC
• Linda Lan-Bo Shi, MD, PHD
• Bruce Edward Shirer, MD
• Olga Shnaider, FNP
• Roya Shoffet-Yaghoubian, DDS,DMD
• Mani Shokoufandeh, DC
• Nadine Shokralla, PHARMD
• Shouridge Group Home

• Family Nurse Practitioner in West Hills, CA
• Providers in West Hills, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.

Verify at the official NPI Registry.