Individual provider Active NPI

Teresa Chrisitine Dionne, FNP-C, MSN

  • Family Nurse Practitioner
  • Santa Clara, CA
National Provider Identifier
1114027638
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP16808 Issued in CA
Practice address
710 Lawrence Expy
Department 282
Santa Clara, CA 95051-5173
Phone
(408) 851-2399
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 577317 CA
Family Nurse Practitioner 363LF0000X NP16808 CA Primary

Addresses

Primary practice location

710 Lawrence Expy
Department 282
Santa Clara, CA 95051-5173

Mailing address

1695 Willow St
San Jose, CA 95125-5107
Phone (408) 365-6272

Other names 1

  • Teresa Christine Cueba Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20070501000682 CA Practitioner - Nurse Practitioner 4688770092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16808CAMDOccupational Therapist
NP16808CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Mar 9, 2011 Accepting new patients
Permanente Medical Group Inc CurrentSince Mar 9, 2011 Accepting new patients

Locations

700 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 851-5300

710 Lawrence Expy
#282
Santa Clara, CA 95051
Phone (408) 851-2399

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1114027638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 WILLOW ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255107",
            "telephone_number": "408-365-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LAWRENCE EXPY",
            "address_2": "DEPARTMENT 282",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515173",
            "telephone_number": "408-851-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIONNE",
        "first_name": "TERESA",
        "middle_name": "CHRISITINE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "577317",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP16808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "CUEBA",
            "middle_name": "CHRISTINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.