Adam Shane Hundley, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95030778 Issued in CA

Practice address

453 S Spring St Ste 400
Los Angeles, CA 90013-2074

Phone

(214) 734-7079

NPI assigned

Jun 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cyrus Nasserian MD Cesar Cruz MD Sambin Wang DO and Zaheib Idrees DGroup PAC ID 3870956246, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cyrus Nasserian MD Cesar Cruz MD Sambin Wang DO and Zaheib Idrees D

  • Psychiatry Physician
  • Covina, CA
  • NPI 1326727074
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1891536041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 S SPRING ST STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132074",
            "telephone_number": "214-734-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 S SPRING ST STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132074",
            "telephone_number": "214-734-7079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 W Route 66 Ste 202",
            "address_purpose": "LOCATION",
            "city": "Glendora",
            "state": "CA",
            "postal_code": "917404335",
            "country_code": "US",
            "telephone_number": "214-734-7079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3257 Cottontail Cir",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917093400",
            "country_code": "US",
            "telephone_number": "214-734-7079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNDLEY",
        "first_name": "ADAM",
        "middle_name": "SHANE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "713755",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95030778",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95030778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hun Kang M.D., Inc.
• Hunanyan Dental Corporation
• Elena Hunanyan, M.D.
• Zana Hundal
• Joddi Hundessa, MSW, ACSW
• Keshia Denise Hundley, MSW
• Melanie Anne Hundt, MD
• Asher Hung
• Chia Lin Hung, MSW INTERN STUDENT
• Christine Hung, MD

• Psychiatric/Mental Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.