Individual provider Active NPI

Elisa Veronica Acevedo Venegas, FNP

  • Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1053926923
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95015273 Issued in CA
Practice address
251 Landis Ave
Chula Vista, CA 91910-2628
Phone
(619) 515-2500
NPI assigned
Sep 8, 2020
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61530719 WA
Nurse Practitioner 363L00000X 95015273 CA Primary
Nurse Practitioner 363L00000X RN254581 GA

Addresses

Primary practice location

251 Landis Ave
Chula Vista, CA 91910-2628

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other names 1

  • Elisa Acevedo Hinson Former name

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
I20241021002264 CA Practitioner - Nurse Practitioner 7911439575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

525 E Main St
El Cajon, CA 92020-4007
Phone (619) 515-2498

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN254581GAMDNurse Practitioner
AP61530719WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Oct 14, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Centro de Salud Familiar Norcross Medical Clinic LLC CurrentSince Oct 17, 2021 Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Oct 14, 2024 Accepting new patients

Locations

251 Landis Ave
Chula Vista, CA 91910
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

5836 Buford Hwy
Ste C
Norcross, GA 30071
Phone (770) 734-9920

Interoperability endpoints

  • Direct secure messaging: elisa.acevedo.1@31019.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1053926923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LANDIS AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102628",
            "telephone_number": "619-515-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO VENEGAS",
        "first_name": "ELISA",
        "middle_name": "VERONICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61530719",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95015273",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN254581",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "HINSON",
            "middle_name": "ACEVEDO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.