Michael Joseph Nicandro Nevarez, DNP, RN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95015602 Issued in CA

Practice address

340 S Lemon Ave # 9892
Walnut, CA 91789-2706

Phone

(415) 403-2156

NPI assigned

Mar 6, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Loma Linda University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Zeam Medical Group IncGroup PAC ID 2466858667, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

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.

• Zeam Medical Group Inc

  • Psychiatry Physician
  • Roseville, CA
  • NPI 1538735071
  Medicare reassignment Care Compare group NPD
• Mindful Health Solutions a Professional Medical Corporation

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1881894483
  Medicare reassignment NPD
• Cerebral Medical Group, a Professional Corporation

  • Psychiatry Physician
  • Glendale, CA
  • NPI 1992355879
  NPD (past)

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1184965709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S LEMON AVE # 9892",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S LEMON AVE # 9892",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892706",
            "telephone_number": "415-403-2156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-3144",
            "fax_number": "909-580-2165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11262 Campus St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923501801",
            "country_code": "US",
            "telephone_number": "909-558-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVAREZ",
        "first_name": "MICHAEL JOSEPH",
        "middle_name": "NICANDRO",
        "credential": "DNP, RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2021-06-25",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "807833",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95015602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Walnut, CA
• Providers in Walnut, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.