Individual provider Active NPI

Alex Joseph Crotteau, FNP

  • Family Nurse Practitioner
  • Escondido, CA
National Provider Identifier
1063925386
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007967 Issued in CA
Practice address
225 E 2ND Ave
Escondido, CA 92025-4249
Phone
(760) 291-6700
Fax
(760) 737-7324
NPI assigned
Nov 8, 2017
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95007967 CA Primary

Addresses

Primary practice location

225 E 2ND Ave
Escondido, CA 92025-4249

Mailing address

225 E 2ND Ave
Escondido, CA 92025-4249
Phone (760) 291-6700

Other identifiers 2

IdentifierTypeStateIssuer
95007967OtherCANURSE PRACTITIONER FURNISHING
95007967OtherCANURSE PRACTITIONER

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
I20180220001247 CA Practitioner - Nurse Practitioner 6608137385 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graybill Medical Group IncGroup PAC ID 9335050517, 103 clinicians

Practice addresses (Care Compare)

225 E 2ND Ave
Escondido, CA 92025-4212
Phone (866) 228-2236

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95007967CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. CurrentSince Dec 3, 2020 Accepting new patients
Graybill Medical Group Inc CurrentSince Jun 1, 2020 Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

225 E 2nd Ave
Escondido, CA 92025

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1063925386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E 2ND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254249",
            "telephone_number": "760-291-6700",
            "fax_number": "760-737-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E 2ND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254249",
            "telephone_number": "760-291-6700",
            "fax_number": "760-737-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROTTEAU",
        "first_name": "ALEX",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-08",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER FURNISHING",
            "identifier": "95007967",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "95007967",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.