RONALD SHISTICK FNP
NPI 1790094928
Nurse Practitioner - Family in West Hills, CA
About Ronald Shistick Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RONALD SHISTICK FNP (NPI 1790094928) is an individual family provider in West Hills, California, licensed in California (19641) and active in the NPI registry since October 2010. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ronald Shistick Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ronald Shistick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
West Hills, CA 91304
- Reassigned Medicare billing, California enrollment
- 205 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ronald Shistick's NPI number?
The NPI number for Ronald Shistick is 1790094928. It was assigned to this individual provider in the NPPES registry on October 5, 2010.
Where is Ronald Shistick located?
Ronald Shistick practices at 7847 Valley Flores Dr, West Hills, CA 91304. The listed phone number is (818) 992-1502.
What is Ronald Shistick's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Ronald Shistick enrolled in Medicare?
Yes. Ronald Shistick is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ronald Shistick's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ronald Shistick reassigns Medicare benefits to Lakeside Medical Organization, A Medical Group Inc. (West Hills, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ronald Shistick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ronald Shistick was last updated on May 31, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ronald Shistick, FNP · NPI 1790094928
Family physician in West Hills, California. Individual provider, active in the CMS NPPES registry since October 5, 2010.
## Identity
- **NPI:** 1790094928 (Entity type: Individual)
- **Enumerated:** October 5, 2010
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 19641 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 7847 VALLEY FLORES DR, West Hills, CA 91304-6105
- **Phone:** (818) 992-1502
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Lakeside Medical Organization, A Medical Group Inc. (NPI 1831426642, West Hills, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 31, 2011
- **Other identifiers:** Medicaid 4444167333 (CA); Medicare PIN 1888444167 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1790094928) · Data from the CMS NPPES public registry.