Individual provider Active NPI

Momoka Nakamura Nishino

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1861349425
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
950378019 Issued in CA
Practice address
2572 Atlantic Ave
Long Beach, CA 90806-2751
Phone
(888) 606-0911
NPI assigned
Mar 12, 2026
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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 950378019 CA Primary

Addresses

Primary practice location

2572 Atlantic Ave
Long Beach, CA 90806-2751

Mailing address

2572 Atlantic Ave
Long Beach, CA 90806-2751

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
I20260428001112 CA Practitioner - Nurse Practitioner 4183191190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Southern California Keck School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West la Medical GroupGroup PAC ID 1658735568, 4 clinicians

Practice addresses (Care Compare)

2572 Atlantic Ave
Long Beach, CA 90806-2751
Phone (818) 774-2755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
950378019CAMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1773273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1861349425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2572 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2572 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062751",
            "telephone_number": "888-606-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA NISHINO",
        "first_name": "MOMOKA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "950378019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.