Individual provider Active NPI

Irene Nevarez, NP

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1003166646
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95009891 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95009891 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other identifiers 1

IdentifierTypeStateIssuer
02850677MedicaidNY

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
I20190423001663 CA Practitioner - Nurse Practitioner 5294077210 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Systems IncGroup PAC ID 8628019320, 37 clinicians

Practice addresses (Care Compare)

5555 Reservoir Dr
204A
San Diego, CA 92120-5134
Phone 61982218002301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95009891CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Nov 19, 2018 Accepting new patients
La Maestra Family Clinic Inc CurrentSince Nov 2, 2021 Accepting new patients
Community Research Foundation Inc CurrentSince Aug 1, 2022 Accepting new patients
Mental Health Systems, Inc. Current Accepting new patients
Regents of the University of California CurrentSince Nov 19, 2018 Accepting new patients
Mental Health Systems, Inc. CurrentSince Aug 9, 2025 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Nov 2, 2021 Accepting new patients
La Maestra Family Clinic, Inc. Current Accepting new patients

Locations

165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347

File 57326
Los Angeles, CA 90074

1465 30th St
Ste K
San Diego, CA 92154
Phone (619) 428-1000

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

9465 Farnham St
San Diego, CA 92123
Phone (858) 576-4311

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

1202 Morena Blvd
Ste 100
San Diego, CA 92110
Phone (619) 276-8112

5555 Reservoir Dr
#204A
San Diego, CA 92120
Phone (619) 822-1800

4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155

Interoperability endpoints

  • Direct secure messaging: irene.nevarez.p1@direct.lamaestra.nextgenshare.com

Organizations & group practices 8

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": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1003166646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVAREZ",
        "first_name": "IRENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95009891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02850677",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.