Individual provider Active NPI

Carl Oriel Raz Lero, NP

  • Acute Care Nurse Practitioner
  • National City, CA
National Provider Identifier
1073360244
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95028468 Issued in CA
Practice address
1419 E 8TH St
National City, CA 91950-2602
Phone
(619) 718-1743
NPI assigned
May 4, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95028468 CA Primary
Orthopedic Registered Nurse 163WX0800X 848788 CA

Addresses

Primary practice location

1419 E 8TH St
National City, CA 91950-2602

Mailing address

9069 Hightail Dr
Santee, CA 92071-2055
Phone (619) 530-9026

Other practice location 1

9069 Hightail Dr
Santee, CA 92071-2055
Phone (619) 530-9026

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
I20251209002227 CA Practitioner - Nurse Practitioner 4385138213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliable Care Medical Group AMC PCGroup PAC ID 8022340785, 5 clinicians

Practice addresses (Care Compare)

1419 E 8TH St
National City, CA 91950-2602
Phone (619) 718-1743

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
848788CAMDOrthopedic Registered Nurse
95028468CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliable Care Medical Group AMC PC CurrentSince Aug 31, 2025 Accepting new patients

Locations

1419 E 8th St
National City, CA 91950
Phone (619) 718-1743

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1073360244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9069 HIGHTAIL DR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920712055",
            "telephone_number": "619-530-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 E 8TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502602",
            "telephone_number": "619-718-1743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9069 Hightail Dr",
            "address_purpose": "LOCATION",
            "city": "Santee",
            "state": "CA",
            "postal_code": "920712055",
            "country_code": "US",
            "telephone_number": "619-530-9026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LERO",
        "first_name": "CARL ORIEL",
        "middle_name": "RAZ",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95028468",
            "primary": true
        },
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "CA",
            "license": "848788",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.