Individual provider Active NPI

Elvia Mexicano, FNP

  • Family Nurse Practitioner
  • Huntington Park, CA
National Provider Identifier
1154057578
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021277 Issued in CA
Practice address
6601 Rugby Ave Ste 300
Huntington Park, CA 90255-4046
Phone
(323) 582-1177
NPI assigned
Jul 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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 95021277 CA Primary

Addresses

Primary practice location

6601 Rugby Ave Ste 300
Huntington Park, CA 90255-4046

Mailing address

1834 Boca Ave
Los Angeles, CA 90032-3749

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et1123.epichosted.comFHIRProxy/api?FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20221011001362 CA Order and Referring Only - Nurse Practitioner 5991171282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1154057578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 BOCA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900323749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 RUGBY AVE STE 300",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554046",
            "telephone_number": "323-582-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEXICANO",
        "first_name": "ELVIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et1123.epichosted.comFHIRProxy/api?FHIR/DSTU2/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6601 Rugby Ave Ste 300",
            "city": "Huntington Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902554046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

Verify at the official NPI Registry.