Individual provider Active NPI

Cyryl R Celiz, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1922612126
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003861 Issued in CA
Practice address
1520 San Pablo St
Los Angeles, CA 90033-5310
Phone
(800) 872-2273
NPI assigned
Sep 4, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 95003861 CA Primary

Addresses

Primary practice location

1520 San Pablo St
Los Angeles, CA 90033-5310

Mailing address

2012 Dorothy St
West Covina, CA 91792-2013
Phone (310) 874-0228

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
I20250414002636 CA Practitioner - Nurse Practitioner 0648794412 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003861CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California Wound Healing Medical Group Inc. Single Specialty CurrentSince Mar 12, 2025 Accepting new patients
Healing Edge Medical Group - Ca Single Specialty CurrentSince Dec 9, 2025 Accepting new patients
New Hope Podiatry Group Inc. Single Specialty PastSince Dec 29, 2024 Accepting new patients

Locations

100 E Huntington Dr
Ste 203
Alhambra, CA 91801

100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146

5800 W Wilson St
Banning, CA 92220
Phone (323) 262-4146

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, 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": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1922612126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 DOROTHY ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922013",
            "telephone_number": "310-874-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "800-872-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELIZ",
        "first_name": "CYRYL",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.