Individual provider Active NPI

Jaedeleen Felizardo Duggan, MSN, FNP-C

  • Family Nurse Practitioner
  • Chino Hills, CA
National Provider Identifier
1245933688
Registry record updated Oct 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023228 Issued in CA
Practice address
15325 Fairfield Ranch Rd Ste 150
Chino Hills, CA 91709-8842
Phone
(909) 557-1600
NPI assigned
Mar 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2023

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 95023228 CA Primary

Addresses

Primary practice location

15325 Fairfield Ranch Rd Ste 150
Chino Hills, CA 91709-8842

Mailing address

15325 Fairfield Ranch Rd Ste 150
Chino Hills, CA 91709-8842
Phone (909) 557-1600

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
I20231116002859 CA Practitioner - Nurse Practitioner 1951758671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Bernardino Medical Orthopaedic Group IncGroup PAC ID 9335045228, 92 clinicians

Practice addresses (Care Compare)

15325 Fairfield Ranch Rd
Suite 150
Chino Hills, CA 91709-8842
Phone (909) 557-1668

1901 W Lugonia Ave
Redlands, CA 92374-9703
Phone (909) 557-1600

400 N Pepper Ave
Arrowhead
Colton, CA 92324-1801
Phone (909) 580-3390

4234 Riverwalk Pkwy
Suite 200
Riverside, CA 92505-3312
Phone (951) 977-2500

Hospital & facility affiliations

  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
  • Riverside Community Hospital Hospital, Riverside, CA, CCN 050022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Oct 2, 2023 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Oct 2, 2023 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Past Accepting new patients

Locations

15325 Fairfield Ranch Rd
Ste 150
Chino Hills, CA 91709
Phone (909) 557-1668

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

1801 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 557-1607

1801 Orange Tree Ln
Ste 240
Redlands, CA 92374

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

4500 Brockton Ave
Ste 306
Riverside, CA 92501
Phone (951) 275-9000

4234 Riverwalk Pkwy
Ste 200
Riverside, CA 92505
Phone (951) 977-2500

4500 Brockton Ave
Riverside, CA 92501
Phone (951) 742-8846

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 2

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": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1245933688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15325 FAIRFIELD RANCH RD STE 150",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917098842",
            "telephone_number": "909-557-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15325 FAIRFIELD RANCH RD STE 150",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917098842",
            "telephone_number": "909-557-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGGAN",
        "first_name": "JAEDELEEN",
        "middle_name": "FELIZARDO",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.