Individual provider Active NPI

Ellina Bernardo, APRN

  • Family Nurse Practitioner
  • Panorama City, CA
National Provider Identifier
1790517993
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030134 Issued in CA
Practice address
9064 Van Nuys Blvd
Panorama City, CA 91402-1813
Phone
(818) 892-9000
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 95030134 CA Primary

Addresses

Primary practice location

9064 Van Nuys Blvd
Panorama City, CA 91402-1813

Mailing address

9064 Van Nuys Blvd
Panorama City, CA 91402-1813

Other names 1

  • Ellina Yentina Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118000030 CA Practitioner - Nurse Practitioner 9032643754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95030134CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kami Adibi MD, Inc CurrentSince Aug 18, 2024 Accepting new patients
First Aid Urgent Care Inc CurrentSince Oct 18, 2024 Accepting new patients

Locations

7204 Foothill Blvd
Tujunga, CA 91042
Phone (818) 237-6200

9064 Van Nuys Blvd
Van Nuys, CA 91402
Phone (818) 352-8333

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1790517993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9064 VAN NUYS BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914021813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9064 VAN NUYS BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914021813",
            "telephone_number": "818-892-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDO",
        "first_name": "ELLINA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLINA",
            "last_name": "YENTINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.