Nancy A Ellerbroek

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

G53683 Issued in CA

Practice address

25751 McBean Pkwy
Ste. 110
Valencia, CA 91355-3701

Phone

(661) 259-2990

Fax

(661) 259-1031

NPI assigned

Nov 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nellerbroek47263@cityofhope.direct-ci.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.

• Gennady Rubinstein MD Inc

  • Dermatology Physician
  • Studio City, CA
  • NPI 1437329273
  Medicare reassignment NPD
• MD Solutions Medical Corp

  • Dermatology Physician
  • Sherman Oaks, CA
  • NPI 1902837735
  Medicare reassignment NPD
• Valley Radiotherapy Associates Medical Group Inc

  • Radiation Oncology Physician
  • Fullerton, CA
  • NPI 1255594925
  NPD (past)
• Queens Medical Radiotherapy PC

  • Radiation Oncology Physician
  • Flushing, NY
  • NPI 1043518905
  NPD (past)

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

{
    "created_epoch": "1133049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1821071507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513969",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513969",
            "telephone_number": "310-335-4065",
            "fax_number": "310-335-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25751 MCBEAN PKWY",
            "address_2": "STE. 110",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553701",
            "telephone_number": "661-259-2990",
            "fax_number": "661-259-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERBROEK",
        "first_name": "NANCY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-27",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G53683",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G53683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19874545",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G536830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elevate Respiratory Therapy Group
• Joseph Elgindy
• Elie Professional Dental Corporation
• Elie Professional Dental Corporation
• Elizabeth Elizarraraz
• Peter K Elloway, D.D.S
• Empathyhandshomecare
• Empowered to Bloom
• Encino Laser and Surgery Center
• Courtney Enfield

• Radiation Oncology Physician in Valencia, CA
• Providers in Valencia, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.