Jose L Corrales Romero

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95016937 Issued in CA

Practice address

510 S Alvarado St
Los Angeles, CA 90057-2904

Phone

(213) 483-3600

NPI assigned

Dec 28, 2020

Sex

Male

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

• Jose L Corrales Romero Former 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritana Medical Clinic,Inc.Group PAC ID 0749370989, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Samaritana Medical Clinic,Inc.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1073706289
  Medicare reassignment Care Compare group NPD
• Samaritana Medical Clinic 7TH Street Inc

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1053799254
  NPD (past)

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1053908863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6159 MAIN ST",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902807923",
            "telephone_number": "323-805-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572904",
            "telephone_number": "213-483-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRALES ROMERO",
        "first_name": "JOSE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-28",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95045071",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95016937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "CORRALES ROMERO",
            "middle_name": "L",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jaime Corral, LCSW
• Michelle Christina Corral, AGACNP-BC
• Monica Corral
• Sulena Corral
• Elizabeth Corrales Padilla
• Cynthia Y Corrales, LCSW
• Haylee Corrales, PSY.D.
• Nury Corrales
• Rhema Eve Corrales
• Xithlalli Abigail Corrales

• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.