Individual provider Active NPI

Sheryl Ronabio Antido, MSN, FNP-C

  • Family Nurse Practitioner
  • Norwalk, CA
National Provider Identifier
1013407519
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008936 Issued in CA
Practice address
12507 Alondra Blvd
Norwalk, CA 90650-7351
Phone
(562) 802-2203
NPI assigned
May 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 95008936 CA Primary

Addresses

Primary practice location

12507 Alondra Blvd
Norwalk, CA 90650-7351

Mailing address

12437 Patricia Dr
Cerritos, CA 90703-7140
Phone (562) 310-6703

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20220623002404 CA Practitioner - Nurse Practitioner 5799164604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adoracion Reyes MD a Professional Medical CorporationGroup PAC ID 3779022181, 3 clinicians

Practice addresses (Care Compare)

11618 S St
Suite 213
Artesia, CA 90701-6618
Phone (562) 310-6703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95008936CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 15, 2022 Accepting new patients
Adoracion Reyes MD a Professional Medical Corporation Family CurrentSince Jul 15, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 15, 2022 Accepting new patients

Locations

11618 South St
Ste 214
Artesia, CA 90701
Phone (562) 278-1678

11618 South St
Ste 213
Artesia, CA 90701
Phone (562) 310-6703

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 4

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1013407519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12437 PATRICIA DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037140",
            "telephone_number": "562-310-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12507 ALONDRA BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906507351",
            "telephone_number": "562-802-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIDO",
        "first_name": "SHERYL",
        "middle_name": "RONABIO",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.