Harina Shaji Mattappally

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014015 Issued in CA

Practice address

6850 Sepulveda Blvd
Van Nuys, CA 91405-4444

Phone

(818) 782-4104

Fax

(818) 475-1823

NPI assigned

Feb 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Los Angeles Hematology-Oncology Medical Group

  • Specialist
  • Los Angeles, CA
  • NPI 1457409674
  NPD
• Los Angeles Hematology-Oncology Medical Group

  • Non-Pharmacy Dispensing Site
  • Glendale, CA
  • NPI 1952516627
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Oxnard, CA
  • NPI 1275756652
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1942834296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21339 BLACKHAWK ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112311",
            "telephone_number": "818-738-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 SEPULVEDA BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054444",
            "telephone_number": "818-782-4104",
            "fax_number": "818-475-1823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 De Soto Ave",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913676701",
            "country_code": "US",
            "telephone_number": "818-719-4813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTAPPALLY",
        "first_name": "HARINA",
        "middle_name": "SHAJI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ghazaleh Matian, O.D.
• Daisy Matias
• Anaid Matinyan
• Natalie Ann Matsumoto, BEHAVIOR ANALYST
• Nicolas Matsumura
• Diane Lucille Matthews, L.C.S.W.
• Mary Matthews
• Graeme Drew Matthewson, MD
• Alexandra Jane Matustik, MS
• Max M Ghannadi MD Medical Corp

• Family Nurse Practitioner in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.