Individual provider Active NPI

Oscar Chavez, FNP

  • Family Nurse Practitioner
  • El Centro, CA
National Provider Identifier
1063880524
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95002909 Issued in CA
Practice address
1600 South Imperial Avenue
Suite 15
El Centro, CA 92243
Phone
(760) 339-2802
Fax
(760) 355-9520
NPI assigned
Sep 14, 2015
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 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 95002909 CA Primary
Family Nurse Practitioner 363LF0000X NP95002909 CA

Addresses

Primary practice location

1600 South Imperial Avenue
Suite 15
El Centro, CA 92243

Mailing address

516 West Aten Road
Suite 2
Imperial, CA 92251-9805
Phone (760) 355-7730

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
I20161004002286 CA Practitioner - Nurse Practitioner 9638467897 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95002909CAMDFamily Nurse Practitioner
NP95002909CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Valley Family Care Medical Group Apc CurrentSince Aug 9, 2016 Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Aug 9, 2016 Accepting new patients
La Suarez a Professional Corporation CurrentSince Jan 1, 2024 Accepting new patients

Locations

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

125 S 5th St
Ste A
Brawley, CA 92227
Phone (760) 344-8100

1550 Pepper Dr
Ste A
El Centro, CA 92243
Phone (323) 843-3668

2061 Ross Ave
Ste B
El Centro, CA 92243
Phone (760) 352-5800

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

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

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1063880524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 WEST ATEN ROAD",
            "address_2": "SUITE 2",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922519805",
            "telephone_number": "760-355-7730",
            "fax_number": "760-355-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SOUTH IMPERIAL AVENUE",
            "address_2": "SUITE 15",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "92243",
            "telephone_number": "760-339-2802",
            "fax_number": "760-355-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "OSCAR",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002909",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95002909",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.