Individual provider Active NPI

Rachel Ann Ardoin, NP

  • Nurse Practitioner
  • Santa Fe Springs, CA
National Provider Identifier
1124634563
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95015034 Issued in CA
Practice address
11721 Telegraph Rd
Santa Fe Springs, CA 90670-3674
Phone
(562) 949-8455
NPI assigned
Sep 21, 2020
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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 95015034 CA Primary

Addresses

Primary practice location

11721 Telegraph Rd
Santa Fe Springs, CA 90670-3674

Mailing address

3939 S Centinela Ave
Los Angeles, CA 90066-4953
Phone (405) 613-3096

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
I20230419001465 CA Practitioner - Nurse Practitioner 2062887334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

11721 Telegraph Rd
Suite a
Santa Fe Springs, CA 90670-6835
Phone (562) 949-8455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95015034CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics Current Accepting new patients
Pacific Clinics CurrentSince Feb 1, 2023 Accepting new patients
Pacific Clinics CurrentSince Feb 1, 2023 Accepting new patients
Revivex Healthcare Inc PastSince Mar 24, 2024 Accepting new patients
Revivex Healthcare Inc PastSince Aug 1, 2021 Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

902 S Myrtle Ave
Monrovia, CA 91016
Phone (626) 303-1541

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

11721 Telegraph Rd
Ste A
Santa Fe Springs, CA 90670
Phone (562) 949-4807

11731 Telegraph Rd
Ste G
Santa Fe Springs, CA 90670
Phone (562) 907-7429

11741 Telegraph Rd
Ste G
Santa Fe Springs, CA 90670
Phone (562) 942-9789

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.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1124634563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 S CENTINELA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664953",
            "telephone_number": "405-613-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11721 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703674",
            "telephone_number": "562-949-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDOIN",
        "first_name": "RACHEL",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95015034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

Verify at the official NPI Registry.