Individual provider Active NPI

Cynthia L Pacheco, AGACNP

  • Acute Care Nurse Practitioner
  • Redlands, CA
National Provider Identifier
1003512088
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95024101 Issued in CA
Practice address
2 W Fern Ave
Redlands, CA 92373-5916
Phone
(909) 793-3311
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95024101 CA Primary

Addresses

Primary practice location

2 W Fern Ave
Redlands, CA 92373-5916

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188

Other practice location 1

6220 Terracina Ave
Rancho Cucamonga, CA 91737-6916
Phone (951) 990-4129

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
I20230210001380 CA Practitioner - Nurse Practitioner 5799157145 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

Hospital & facility affiliations

  • Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 16, 2024 Accepting new patients
Beaver Medical Group P C CurrentSince Feb 1, 2023 Accepting new patients
Beaver Medical Group P C CurrentSince Feb 1, 2023 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 16, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Beaver Medical Group P C Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cpacheco1085926@direct.llu.edu

Organizations & group practices 11

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 1

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1003512088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W FERN AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735916",
            "telephone_number": "909-793-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6220 Terracina Ave",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917376916",
            "country_code": "US",
            "telephone_number": "951-990-4129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95024101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.