Laurene Bandolin, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95022508 Issued in CA

Practice address

1100 W Town and Country Rd Ste 1300
Orange, CA 92868-4654

Phone

(855) 434-7763

NPI assigned

Jan 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Laurene Sandoval Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://api.platform.athenahealth.com/19831/brand/2/csg/1/fhir/r4

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.

• California PHS PC

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1649932781
  NPD
• J M Geiss DO Apc

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1063825289
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1053025239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22885 HILTON HEAD DR UNIT 263",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684654",
            "telephone_number": "855-434-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDOLIN",
        "first_name": "LAURENE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95036098",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURENE",
            "last_name": "SANDOVAL",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Monica Banaag
• Melissa Banaban, S.L.P.A.
• Manisha Banala
• Carlos Adrian Banda Chavez
• Juan Pablo Banda
• Oliver Bandonell, CRNA
• Dipti Banerjee, MD
• Shoujit Banerjee
• Soo CHI Bang, PA-C
• Timothy Bang

• All providers in Orange, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.