Individual provider Active NPI

Cynthia Cuellar, FNP

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1104351121
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010175 Issued in CA
Practice address
4600 Panama LN
Suite 102B
Bakersfield, CA 93313-3509
Phone
(800) 300-6664
NPI assigned
Apr 27, 2017
Last updated
Nov 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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 95010175 CA Primary
Registered Nurse 163W00000X 822343 CA

Addresses

Primary practice location

4600 Panama LN
Suite 102B
Bakersfield, CA 93313-3509

Mailing address

4900 California Ave
Suite 400B
Bakersfield, CA 93309-7024
Phone (661) 459-1900

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
I20181214002097 CA Practitioner - Nurse Practitioner 9436494788 Reassigns benefits to 1 organization

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
Omni Family HealthGroup PAC ID 9234176363, 93 clinicians

Practice addresses (Care Compare)

210 N Chester Ave
Bakersfield, CA 93308-4841
Phone (866) 707-6664

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95010175CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Family Health CurrentSince Nov 1, 2018 Accepting new patients
Omni Family Health CurrentSince Nov 1, 2018 Accepting new patients
Dignity Health Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Omni Family Health Past Accepting new patients

Locations

1701 Stine Rd
Bakersfield, CA 93309
Phone (661) 770-3317

210 N Chester Ave
Bakersfield, CA 93308
Phone (661) 325-6800

3800 Mall View Rd
Bakersfield, CA 93306

4600 Panama Ln
Unit 102B
Bakersfield, CA 93313
Phone (661) 630-7732

4900 California Ave
Ste 400B
Bakersfield, CA 93309
Phone (661) 630-7046

277 E Front St
Buttonwillow, CA 93206
Phone (661) 630-7381

655 S Central Valley Hwy
Shafter, CA 93263
Phone (661) 459-1927

659 S Central Valley Hwy
Shafter, CA 93263
Phone (661) 459-1913

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cynthia.cuellar.1@17363.direct.athenahealth.com
  • Direct secure messaging: cynthia.cuellar.p1@direct.omnifamilyhealth.nextgenshare.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 1

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": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1104351121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 CALIFORNIA AVE",
            "address_2": "SUITE 400B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933097024",
            "telephone_number": "661-459-1900",
            "fax_number": "661-459-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 PANAMA LN",
            "address_2": "SUITE 102B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933133509",
            "telephone_number": "800-300-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "CYNTHIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010175",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "822343",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.