Individual provider Active NPI

Cliff Fontelera, CRNA

  • Certified Registered Nurse Anesthetist
  • Riverside, CA
National Provider Identifier
1114075033
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA3067 Issued in CA
Practice address
10800 Magnolia Ave
Riverside, CA 92505-3043
Phone
(909) 353-2000
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA3067 CA Primary

Addresses

Primary practice location

10800 Magnolia Ave
Riverside, CA 92505-3043

Mailing address

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (909) 353-2000

Other practice location 1

1310 W Stewart Dr Ste 310
Orange, CA 92868-3838
Phone (714) 633-1338

Other practice location 2

207 S Santa Anita St Ste G16
San Gabriel, CA 91776-1147
Phone (626) 300-5300

Other practice location 3

44139 Monterey Ave Ste B
Palm Desert, CA 92260-8700
Phone (760) 773-4411

Other practice location 4

700 W El Norte Pkwy
Escondido, CA 92026-3923
Phone (760) 738-7830

Other practice location 5

44815 Fig Ave Ste 100
Lancaster, CA 93534-3144
Phone (844) 408-6589

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000462 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416991344 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical Group 11,250 clinicians
San Gabriel Anesthesia Associates, PC 16 clinicians

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

44139 Monterey Ave
Suite B
Palm Desert, CA 92260-8700
Phone (760) 779-5599

Hospital & facility affiliations

  • Kaiser Foundation Hospital, Riverside Hospital, Riverside, CA, CCN 050686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
3067CAMDGerontology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Allied Anesthesia Medical Group Inc CurrentSince Jan 2, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 18, 2006 Accepting new patients
San Gabriel Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Aug 23, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 18, 2006 Accepting new patients

Locations

288 N Santa Anita Ave
Ste 404
Arcadia, CA 91006
Phone (626) 289-2223

700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

44815 Fig Ave
Ste 100
Lancaster, CA 93534
Phone (661) 802-7978

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

44139 Monterey Ave
Ste B
Palm Desert, CA 92260
Phone (760) 773-4411

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

207 S Santa Anita St
Ste G16
San Gabriel, CA 91776
Phone (626) 289-2223

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Organizations & group practices 8

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.

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1114075033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053043",
            "telephone_number": "909-353-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053043",
            "telephone_number": "909-353-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 W Stewart Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683838",
            "country_code": "US",
            "telephone_number": "714-633-1338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 S Santa Anita St Ste G16",
            "address_purpose": "LOCATION",
            "city": "San Gabriel",
            "state": "CA",
            "postal_code": "917761147",
            "country_code": "US",
            "telephone_number": "626-300-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44139 Monterey Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922608700",
            "country_code": "US",
            "telephone_number": "760-773-4411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 W El Norte Pkwy",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920263923",
            "country_code": "US",
            "telephone_number": "760-738-7830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44815 Fig Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935343144",
            "country_code": "US",
            "telephone_number": "844-408-6589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTELERA",
        "first_name": "CLIFF",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-11-29",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA3067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.