Individual provider Active NPI

Jessica Muthoni Ndiritu, FNP

  • Family Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1205507142
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018510 Issued in CA
Practice address
1901 4TH St
Berkeley, CA 94710-1985
Phone
(510) 929-1400
Fax
(510) 929-1414
NPI assigned
Sep 21, 2021
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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 95018510 CA Primary

Addresses

Primary practice location

1901 4TH St
Berkeley, CA 94710-1985

Mailing address

PO Box 511250
Los Angeles, CA 90051-7805
Phone (510) 929-1400

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
I20240502003632 CA Practitioner - Nurse Practitioner 9931549276 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
Pine Park Health, IncGroup PAC ID 0345670527, 21 clinicians

Practice addresses (Care Compare)

Berkeley, CA 94710
Phone (510) 929-1400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Park Health, Inc Nurse Practitioner CurrentSince Apr 8, 2024 Accepting new patients

Locations

1901 4th St
Ste 201
Berkeley, CA 94710
Phone (469) 401-8820

22445 Cupertino Rd
Cupertino, CA 95014
Phone (408) 253-4300

3850 Walnut Ave
Fremont, CA 94538
Phone (341) 206-8344

16977 Healdsburg Ave
Healdsburg, CA 95448

1144 65th St
Ste F
Oakland, CA 94608
Phone (510) 919-1400

9800 Glen Center Dr
San Diego, CA 92131
Phone (858) 832-2500

1444 McAllister St
San Francisco, CA 94115
Phone (415) 305-4002

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21048/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jessica.ndiritu@299395540647940.direct.elationemr.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1205507142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511250",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900517805",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 4TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947101985",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIRITU",
        "first_name": "JESSICA",
        "middle_name": "MUTHONI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.