Individual provider Active NPI

Andrew Pascual, DNP

  • Acute Care Nurse Practitioner
  • Sherman Oaks, CA
National Provider Identifier
1871092254
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95008560 Issued in CA
Practice address
4929 Van Nuys BLVS
Sherman Oaks, CA 91403
Phone
(818) 528-1260
NPI assigned
Feb 12, 2018
Last updated
Apr 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 95008560 CA
Acute Care Nurse Practitioner 363LA2100X 95008560 CA Primary

Addresses

Primary practice location

4929 Van Nuys BLVS
Sherman Oaks, CA 91403

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

757 Westwood Plz
Los Angeles, CA 90095-8358
Phone (310) 825-9111

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
I20180409001458 CA Practitioner - Nurse Practitioner 8729341524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Medical Group,IncGroup PAC ID 4385883958, 54 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 308
Sherman Oaks, CA 91403-1811
Phone (818) 528-1260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95008560CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Group,Inc CurrentSince Mar 20, 2018 Accepting new patients
Derderyan Medical Group Inc. CurrentSince Dec 1, 2018 Accepting new patients

Locations

501 W Glenoaks Blvd
Ste 26
Glendale, CA 91202

4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403
Phone (818) 528-1222

4929 Van Nuys Blvd
Van Nuys, CA 91403
Phone (818) 907-4561

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

16850 Bear Valley Rd
Victorville, CA 92395

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1871092254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 VAN NUYS BLVS",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91403",
            "telephone_number": "818-528-1260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958358",
            "country_code": "US",
            "telephone_number": "310-825-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-12",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "95008560",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95008560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.