Dondon Restrivera Edeza

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006889 Issued in CA

Practice address

3605 Hospital Rd
Atwater, CA 95301-5173

Phone

(209) 726-1235

NPI assigned

Jul 18, 2017

Last updated

Jul 18, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dondon.edeza.d1.p1@direct.castle.nextgenshare.com

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.

• Castle Family Health Centers Inc

  • Urgent Care Clinic/Center
  • Atwater, CA
  • NPI 1629246624
  Medicare reassignment NPD
• Castle Family Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Winton, CA
  • NPI 1447281746
  NPD

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1073036380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 TILLERMAN DR",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953014787",
            "telephone_number": "209-726-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 HOSPITAL RD",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953015173",
            "telephone_number": "209-726-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEZA",
        "first_name": "DONDON",
        "middle_name": "RESTRIVERA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Duarte
• Jennifer Dugo
• Dva Renal Healthcare Inc (Atwater Dialysis)
• Easy Care Medical Transport Inc
• Vanessa Echevarria
• Edward a. Vanek, D.O., Inc.
• Maxwell Effah
• Cypra Ellison-Marshal
• Jessica Emerzian
• Mardie Encenzo

• Family Nurse Practitioner in Atwater, CA
• Providers in Atwater, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.