Individual provider Active NPI

Laura Suzanne Raty-Kerstetter, FNP-C

  • Family Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1265069025
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013202 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(858) 354-6889
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 699744 CA
Family Nurse Practitioner 363LF0000X 95013202 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

3009 Tiffany LN
Colton, CA 92324-9215
Phone (858) 354-6889

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
I20200519002636 CA Practitioner - Nurse Practitioner 2668803040 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Justin C Kerstetter MD IncGroup PAC ID 5395287460, 2 clinicians

Practice addresses (Care Compare)

308 W State St
Suite 3a
Redlands, CA 92373-4653
Phone (909) 435-6758

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 2, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Justin C. Kerstetter, M.D., Inc. CurrentSince Mar 18, 2024 Accepting new patients
Beaver Medical Group P C CurrentSince Mar 3, 2022 Accepting new patients
Beaver Medical Group P C CurrentSince Mar 3, 2022 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

7000 Boulder Ave
Highland, CA 92346

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
Fl 6
Loma Linda, CA 92350

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

308 W State St
Ste 3A
Redlands, CA 92373
Phone (909) 435-6758

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

Interoperability endpoints

  • Direct secure messaging: lratykerstetter20407@epiclp.direct-ci.com

Organizations & group practices 10

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1265069025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 TIFFANY LN",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923249215",
            "telephone_number": "858-354-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "858-354-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATY-KERSTETTER",
        "first_name": "LAURA",
        "middle_name": "SUZANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "699744",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.