Individual provider Active NPI

Elisha Phelan, FNP

  • Family Nurse Practitioner
  • Escondido, CA
National Provider Identifier
1033424569
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22874 Issued in CA
Practice address
460 N Elm St
Escondido, CA 92025-3002
Phone
(760) 520-8100
Fax
(360) 462-2745
NPI assigned
Aug 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2261734 MA
Family Nurse Practitioner 363LF0000X 22874 CA Primary

Addresses

Primary practice location

460 N Elm St
Escondido, CA 92025-3002

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

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
I20170425003055 CA Practitioner - Nurse Practitioner 1658565494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

460 N Elm St
Escondido, CA 92025-3002
Phone (760) 520-8100

855 E Madison Ave
El Cajon, CA 92020-3819
Phone (619) 440-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22874CAMDAmbulatory Care Registered Nurse
RN2261734MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Feb 19, 2024 Accepting new patients
Neighborhood Healthcare CurrentSince Feb 19, 2024 Accepting new patients
Joslin Clinic Inc Past Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

425 N Date St
#0
Escondido, CA 92025

460 N Elm St
Escondido, CA 92025
Phone (760) 520-8100

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

1030 E Florida Ave
Hemet, CA 92543
Phone (951) 216-6100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1033424569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N ELM ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253002",
            "telephone_number": "760-520-8100",
            "fax_number": "360-462-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "ELISHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2261734",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.