Individual provider Active NPI

Nada El-Ghezzaoui

  • Physician Assistant
  • New York, NY
National Provider Identifier
1922652916
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
440 Broome St FL 2
New York, NY 10013-3569
Phone
(646) 650-5337
Fax
(646) 871-6820
NPI assigned
Jul 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 030815 NY
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

440 Broome St FL 2
New York, NY 10013-3569

Mailing address

14632 Sweetan St
Irvine, CA 92604-2428
Phone (949) 214-7640

Other practice location 1

1075 Camino Del Rio S
San Diego, CA 92108-3538
Phone (619) 881-4516

Other practice location 2

4425 S Central Ave
Los Angeles, CA 90011-3629
Phone (323) 908-4200

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
I20250120000686 CA Practitioner - Physician Assistant 8123466943 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
030815NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Family Health Center CurrentSince Oct 25, 2024 Accepting new patients
South Central Family Health Center CurrentSince Oct 25, 2024 Accepting new patients

Locations

4425 S Central Ave
Los Angeles, CA 90011

3410 Hooper Ave
Los Angeles, CA 90011

Interoperability endpoints

  • Direct secure messaging: nada.elghezzaoui.p1@direct.scfhc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1922652916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14632 SWEETAN ST",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926042428",
            "telephone_number": "949-214-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 BROOME ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133569",
            "telephone_number": "646-650-5337",
            "fax_number": "646-871-6820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 Camino Del Rio S",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083538",
            "country_code": "US",
            "telephone_number": "619-881-4516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4425 S Central Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900113629",
            "country_code": "US",
            "telephone_number": "323-908-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EL-GHEZZAOUI",
        "first_name": "NADA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-28",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030815",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.