Individual provider Active NPI

Fiji Simmons, FNP-BC

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1124659685
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10009898 Issued in OR
Practice address
11150 W Olympic Blvd Ste 780
Los Angeles, CA 90064-1829
Phone
(213) 721-1571
Fax
(213) 721-1578
NPI assigned
Feb 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10009898 OR Primary
Pain Management Registered Nurse 163WP0000X 671631 CA
Family Nurse Practitioner 363LF0000X 95016622 CA
Nurse Practitioner 363L00000X 95016622 CA

Addresses

Primary practice location

11150 W Olympic Blvd Ste 780
Los Angeles, CA 90064-1829

Mailing address

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone (760) 684-4143

Other practice location 1

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone (760) 684-4143

Other identifiers 1

IdentifierTypeStateIssuer
500828290MedicaidOR

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
I20210525001766 CA Practitioner - Nurse Practitioner 6608275631 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tobias Moeller-Bertram MD CorporationGroup PAC ID 1456586064, 56 clinicians

Practice addresses (Care Compare)

12640 Hesperia Rd
Suite D
Victorville, CA 92395-7753
Phone (760) 684-4143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95016622CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Nurse Practitioner CurrentSince Jun 30, 2022 Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Dec 16, 2021 Accepting new patients
Minuteclinic Diagnostic Medical Group of San Diego Inc Family CurrentSince Dec 16, 2021 Accepting new patients
Seasons Hospice & Palliative Care of California- San Bernardino, LLC PastSince May 24, 2021 Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

2760 Fletcher Pkwy
El Cajon, CA 92020
Phone 6194614411 ext. 8221

2456 S Grove Ave
Ontario, CA 91761
Phone (909) 947-9390

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

4829 Clairemont Dr
San Diego, CA 92117
Phone (858) 273-5300

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3154

2791 Agoura Rd
Westlake Village, CA 91361
Phone 8054954938 ext. 8221

Interoperability endpoints

  • Direct secure messaging: fsimmons@landmarkhealth-direct.org
  • Direct secure messaging: fiji.simmons.1@31321.direct.athenahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1124659685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE D",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "760-684-4143",
            "fax_number": "764-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 W OLYMPIC BLVD STE 780",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641829",
            "telephone_number": "213-721-1571",
            "fax_number": "213-721-1578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12640 Hesperia Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923957753",
            "country_code": "US",
            "telephone_number": "760-684-4143",
            "fax_number": "764-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "FIJI",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10009898",
            "primary": true
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "CA",
            "license": "671631",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016622",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95016622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500828290",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.