Individual provider Active NPI

Hilario Cruzada Noveno Jr., PHD, NP-C

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1124486865
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95010779 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Feb 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95010779 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

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
I20190520002746 CA Practitioner - Nurse Practitioner 1951644608 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6753

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Nov 1, 2021 Accepting new patients
Regents of the University of California CurrentSince Nov 1, 2021 Accepting new patients
GN Medical Associates, Inc. CurrentSince Mar 17, 2019 Accepting new patients
Neuromatters and Wellness a Professional Nursing Practice Corporation CurrentSince Sep 7, 2025 Accepting new patients
Mansour Mofidi, D.O.,Inc CurrentSince Sep 6, 2023 Accepting new patients
Saleem Rajper Medical Corporation CurrentSince Sep 6, 2023 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

5119 Garfield St
La Mesa, CA 91941
Phone (619) 460-4055

914 E 8th St
Ste 210
National City, CA 91950
Phone (619) 306-3920

4520 Executive Dr
San Diego, CA 92121
Phone (858) 249-1429

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4168 Front St
San Diego, CA 92103
Phone (619) 471-0420

1101 Felspar St
San Diego, CA 92109
Phone (858) 274-0300

1750 Montgomery St
Fl 1
San Francisco, CA 94111
Phone (714) 619-8777

3401 W Sunflower Ave
#250
Santa Ana, CA 92704
Phone (415) 848-8258

Organizations & group practices 9

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": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1124486865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVENO",
        "first_name": "HILARIO",
        "middle_name": "CRUZADA",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.