Individual provider Active NPI

Yusleydys Panade Roman, NP

  • Family Nurse Practitioner
  • Upland, CA
National Provider Identifier
1003652579
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030929 Issued in CA
Practice address
1020 W 16TH St
Upland, CA 91784-1803
Phone
(626) 642-6977
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95030929 CA Primary

Addresses

Primary practice location

1020 W 16TH St
Upland, CA 91784-1803

Mailing address

1020 W 16TH St
Upland, CA 91784-1803
Phone (626) 642-6977

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
I20241024004152 CA Practitioner - Nurse Practitioner 2062945371 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
California Wound Healing Medical Group Inc.Group PAC ID 7315033198, 21 clinicians
Journey Care SolutionsGroup PAC ID 2365967999, 3 clinicians

Practice addresses (Care Compare)

100 E Huntington Dr
Suite 209
Alhambra, CA 91801-1022
Phone (323) 264-7796

14141 Covello St
Suite 9C
Van Nuys, CA 91405-1448
Phone (818) 465-5772

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Wound Care, Inc Current Accepting new patients
California Wound Healing Medical Group Inc. CurrentSince Sep 16, 2024 Accepting new patients
FM Woundcare Inc CurrentSince Jan 17, 2026 Accepting new patients
New Hope Podiatry Group Inc. CurrentSince Dec 29, 2024 Accepting new patients
Healing Edge Medical Group - Ca CurrentSince Dec 9, 2025 Accepting new patients

Locations

100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146

100 E Huntington Dr
Ste 203
Alhambra, CA 91801

5800 W Wilson St
Banning, CA 92220
Phone (323) 262-4146

Organizations & group practices 6

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": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1003652579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W 16TH ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841803",
            "telephone_number": "626-642-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W 16TH ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841803",
            "telephone_number": "626-642-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANADE ROMAN",
        "first_name": "YUSLEYDYS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.