Individual provider Active NPI

Peter Arnold Swanson, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1992839120
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95002363 Issued in CA
Practice address
1540 E Colorado St
Glendale, CA 91205-1514
Phone
(818) 244-7257
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 666762-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95002363 CA Primary

Addresses

Primary practice location

1540 E Colorado St
Glendale, CA 91205-1514

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

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
I20151026000251 CA Practitioner - Nurse Practitioner 0345559779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Didi Hirsch Psychiatric ServiceGroup PAC ID 3870537194, 17 clinicians

Practice addresses (Care Compare)

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
666762-1NYMDAdult Psychiatric/Mental Health Registered Nurse
95002363CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Didi Hirsch Psychiatric Service CurrentSince Aug 9, 2015 Accepting new patients
Didi Hirsch Psychiatric Service CurrentSince Aug 9, 2015 Accepting new patients

Locations

1540 E Colorado St
Glendale, CA 91205
Phone (818) 244-7257

4760 Sepulveda Blvd
Los Angeles, CA 90230
Phone (310) 751-5344

Organizations & group practices 2

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1992839120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051514",
            "telephone_number": "818-244-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "PETER",
        "middle_name": "ARNOLD",
        "name_prefix": "Mr.",
        "credential": "RN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "666762-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95002363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.