Individual provider Active NPI

Jane Thu Himmelvo, M.D.

  • Family Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1235170440
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A95816 Issued in CA
Practice address
5131 Nellie CT
Rancho Cucamonga, CA 91739-5132
Phone
(213) 841-4181
Fax
(909) 621-1397
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M2180 TX
Family Medicine Physician 207Q00000X A95816 CA Primary

Addresses

Primary practice location

5131 Nellie CT
Rancho Cucamonga, CA 91739-5132

Mailing address

5131 Nellie CT
Rancho Cucamonga, CA 91739-5132
Phone (213) 841-4181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20061218000587 CA Practitioner - Family Practice 9830198977 Reassigns benefits to 2 organizations
I20170718001516 TX Practitioner - Family Practice 9830198977
I20240521004358 WA Practitioner - Family Practice 9830198977

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Medical PracticeGroup PAC ID 3173050994, 4 clinicians

Practice addresses (Care Compare)

8891 Central Ave
Suite a
Montclair, CA 91763-1685
Phone (432) 294-5833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Zachary, D.O., P.C. Family Medicine CurrentSince Oct 1, 2021 Accepting new patients
Central Primary Care Current Accepting new patients
Central Medical Practice CurrentSince Dec 1, 2024 Accepting new patients
Above Urgent Care Center CurrentSince Sep 1, 2023 Accepting new patients
Thuy T M Nguyen M D Inc PastSince Sep 1, 2023 Accepting new patients
California Care Level Management Direct Medical Group, Inc PastSince Jun 26, 2006 Accepting new patients

Locations

7111 N Fresno St
Ste 200
Fresno, CA 93720
Phone (415) 353-6817

8891 Central Ave
Ste A
Montclair, CA 91763
Phone (432) 294-5833

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jhimmelvo12464@cchealth.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGGFDD/Endpoint/CGGFDD

Organizations & group practices 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1235170440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5131 NELLIE CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917395132",
            "telephone_number": "213-841-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 NELLIE CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917395132",
            "telephone_number": "213-841-4181",
            "fax_number": "909-621-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMMELVO",
        "first_name": "JANE",
        "middle_name": "THU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M2180",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A95816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.