Individual provider Active NPI

Marcie L Nomura, ACNP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1962799023
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
20356 Issued in CA
Practice address
757 Westwood PLZ Ste 8638
Los Angeles, CA 90095-0001
Phone
(310) 267-7834
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 20356 CA Primary
General Acute Care Hospital 282N00000X NP 20356 CA

Addresses

Primary practice location

757 Westwood PLZ Ste 8638
Los Angeles, CA 90095-0001

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

200 Medical Plaza Suite 214
Los Angeles, CA 90095-0001
Phone (310) 267-9259

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
I20161213000478 CA Practitioner - Nurse Practitioner 9638459456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 7911970736, 38 clinicians

Practice addresses (Care Compare)

757 Westwood PLZ
Los Angeles, CA 90095-8358

950 Charles Young Dr
Suite 77 120
Los Angeles, CA 90095-0001
Phone (310) 825-5318

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20356CAMDSpeech-Language Pathologist
NP 20356CAMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Nov 7, 2016 Accepting new patients
The Regents of the University of California CurrentSince Feb 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Nov 7, 2016 Accepting new patients
UCLA Medical Group Past Accepting new patients
UC Regents Past Accepting new patients

Locations

757 Westwood Plz
Ste 8638
Los Angeles, CA 90095
Phone (310) 267-7834

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 54206
Los Angeles, CA 90074

1441 Eastlake Ave
Ste 3412
Los Angeles, CA 90089

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

200 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-6688

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: mnomura418252@direct.uclahealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1962799023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 8638",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-267-7834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Medical Plaza Suite 214",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900950001",
            "country_code": "US",
            "telephone_number": "310-267-9259",
            "fax_number": "310-983-3570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOMURA",
        "first_name": "MARCIE",
        "middle_name": "L",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "20356",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "NP 20356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.