Individual provider Active NPI

Siming Chen, FNP-C

  • Family Nurse Practitioner
  • Northridge, CA
National Provider Identifier
1790525251
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022958 Issued in CA
Practice address
8510 Balboa Blvd Ste 150
Northridge, CA 91325-5810
Phone
(818) 654-3400
Fax
(818) 933-0525
NPI assigned
May 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 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 95022958 CA Primary

Addresses

Primary practice location

8510 Balboa Blvd Ste 150
Northridge, CA 91325-5810

Mailing address

8510 Balboa Blvd Ste 150
Northridge, CA 91325-5810
Phone (818) 654-3400

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
I20240726000018 CA Practitioner - Nurse Practitioner 2961948948 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95022958CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. CurrentSince Jun 16, 2024 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. PastSince Jun 16, 2024 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

12660 Riverside Dr
Ste 310320
North Hollywood, CA 91607
Phone (818) 755-0391

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

Interoperability endpoints

  • Direct secure messaging: siming.chen.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 3

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": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1790525251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD STE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255810",
            "telephone_number": "818-654-3400",
            "fax_number": "818-933-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD STE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255810",
            "telephone_number": "818-654-3400",
            "fax_number": "818-933-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "SIMING",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.