Individual provider Active NPI

Andre Cristian De Jesus, RN, FNP, MBA

  • Family Nurse Practitioner
  • Murrieta, CA
National Provider Identifier
1023549037
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006285 Issued in CA
Practice address
24640 Jefferson Ave Ste 208
Murrieta, CA 92562
Phone
(877) 448-3627
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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 95006285 CA Primary

Addresses

Primary practice location

24640 Jefferson Ave Ste 208
Murrieta, CA 92562

Mailing address

901 McClintock Dr Ste 202
Burr Ridge, IL 60527-0872

Other practice location 1

512 S Glendora Ave
West Covina, CA 91790-3022
Phone (626) 337-2888

Other practice location 2

512 S Glendora Ave
West Covina, CA 91790-3022
Phone (626) 337-2888

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
I20190513000264 CA Practitioner - Nurse Practitioner 2466795547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

2220 Lynn Rd
Suite 301
Thousand Oaks, CA 91360-8005
Phone (805) 495-1073

24640 Jefferson Ave
Suite 208
Murrieta, CA 92562-9027
Phone (951) 395-5457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95006285CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants LLC CurrentSince Mar 8, 2019 Accepting new patients
Metro Infectious Disease Consultants, LLC CurrentSince Mar 8, 2019 Accepting new patients
Mark H Mazur MD & Barry Statner MD a Professional Corporation CurrentSince Apr 18, 2023 Accepting new patients
Metro Infectious Disease Consultants, LLC Past Accepting new patients
Metro Infusion Center PLLC Past Accepting new patients

Locations

17768 Wika Rd
Ste 200
Apple Valley, CA 92307
Phone (760) 503-1700

2360 E Bidwell St
Ste 107
Folsom, CA 95630
Phone (916) 220-2951

4980 Barranca Pkwy
Ste 195
Irvine, CA 92604
Phone (949) 398-5280

4037 Hardwick St
Lakewood, CA 90712

1174 Castro St
Ste 150
Mountain View, CA 94040

24640 Jefferson Ave
Ste 208
Murrieta, CA 92562
Phone (951) 395-5457

301 S Fair Oaks Ave
Ste 304
Pasadena, CA 91105
Phone (626) 960-2711

15706 Pomerado Rd
Ste S202
Poway, CA 92064

9050 Fairway Dr
Ste 125
Roseville, CA 95678

27699 Jefferson Ave
Ste 311
Temecula, CA 92590
Phone (951) 693-1159

375 Rolling Oaks Dr
Ste 210
Thousand Oaks, CA 91361
Phone (805) 495-1073

2220 Lynn Rd
Ste 301
Thousand Oaks, CA 91360
Phone (805) 495-1073

130 La Casa Via
Ste 108
Walnut Creek, CA 94598

901 McClintock Dr
Ste 201
Burr Ridge, IL 60527
Phone (630) 654-4201

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

Organizations & group practices 5

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1023549037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DR STE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24640 JEFFERSON AVE STE 208",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "92562",
            "telephone_number": "877-448-3627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 S Glendora Ave",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917903022",
            "country_code": "US",
            "telephone_number": "626-337-2888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "512 S Glendora Ave",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917903022",
            "country_code": "US",
            "telephone_number": "626-337-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "ANDRE CRISTIAN",
        "name_prefix": "Mr.",
        "credential": "RN, FNP, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.