Individual provider Active NPI

Dan Jin Lau

  • Family Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1144760893
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005863 Issued in CA
Practice address
7140 Indiana Ave
Riverside, CA 92504-4544
Phone
(951) 358-6000
NPI assigned
Feb 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005863 CA Primary

Addresses

Primary practice location

7140 Indiana Ave
Riverside, CA 92504-4544

Mailing address

7140 Indiana Ave
Riverside, CA 92504-4544

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
I20170914002081 CA Practitioner - Nurse Practitioner 8820362858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

7140 Indiana Ave
Riverside, CA 92504-4544
Phone (951) 358-6000

Hospital & facility affiliations

  • Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95005863CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Aug 2, 2017 Accepting new patients
County of Riverside CurrentSince Aug 2, 2017 Accepting new patients
County of Riverside Current Accepting new patients

Locations

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

7140 Indiana Ave
Riverside, CA 92504
Phone (909) 358-6035

Interoperability endpoints

  • Direct secure messaging: dlau103809@direct.llu.edu

Organizations & group practices 3

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": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1144760893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7140 INDIANA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7140 INDIANA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044544",
            "telephone_number": "951-358-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "DAN",
        "middle_name": "JIN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.