Nida Kichkla, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95011993 Issued in CA

Practice address

510 S Grand Ave Ste 200
Glendora, CA 91741-4291

Phone

(626) 914-1980

NPI assigned

Jun 22, 2019

Last updated

Jun 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

William Gillespie and Associates IncGroup PAC ID 7517181373, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Gabriel Valley Medical Center Hospital, San Gabriel, CA, CCN 050132

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• William Gillespie and Associates Inc.

  dba Gillespie and Associates

  • Psychiatry Physician
  • Glendora, CA
  • NPI 1558771246
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahmc San Gabriel Valley Medical

  dba AHMC San Gabreil Valley Medical Center, LP

  • General Acute Care Hospital
  • San Gabriel, CA
  • NPI 1275720377
  Care Compare affiliation

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

{
    "created_epoch": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1962063859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N AVENUE 66",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421512",
            "telephone_number": "626-374-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S GRAND AVE STE 200",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414291",
            "telephone_number": "626-914-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICHKLA",
        "first_name": "NIDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95011993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Sue Key, FNP, PHN, RN
• Tanyia Khadem, MA. CCC-SLP
• Waseem Ekram Sedhom Khalil, RPH
• Ayesha Khan Hawkins, M.S.P.T.
• Naveed Abas Khan, MD
• Kathleen Kiely, RPH
• Christopher Kim
• David Y Kim, PA-C
• Grace Kim, PH.D.
• Grace Mijin Kim, DDS

• Psychiatric/Mental Health Nurse Practitioner in Glendora, CA
• Providers in Glendora, 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 Jun 21, 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.
• 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.