Carlos F Eltagunde, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95011295 Issued in CA

Practice address

3940 Sandpiper Ave
Merced, CA 95340-8372

Phone

(866) 682-4842

Fax

(209) 381-4109

NPI assigned

Apr 25, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Merced, CA
  • NPI 1508333253
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1922249077
  NPD
• Bristol Hospice - California, LLC

  • Community Based Hospice Care Agency
  • Merced, CA
  • NPI 1487603452
  NPD (past)
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)
• Go Gently Medical Group, Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Clackamas, OR
  • NPI 1891397931
  NPD (past)

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1265096101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 AVIGNON DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953489547",
            "telephone_number": "209-388-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 SANDPIPER AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408372",
            "telephone_number": "866-682-4842",
            "fax_number": "209-381-4109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "374 E Yosemite Ave # 200",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953409100",
            "country_code": "US",
            "telephone_number": "209-384-1415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELTAGUNDE",
        "first_name": "CARLOS",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95011295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Charles Elias Jr.
• Catalina Eliserio
• Maria Pacheco Elizalde, LMFT
• Elk Grove Dermatology
• Regina Ellzey
• Sousita Bangon Emanivong
• Emeritus Corporation
• Shawn Clark Emery, M.D.
• Ronald Emmerson, D.C.
• Teresita Sargadilos Enad, M.D.

• Nurse Practitioner in Merced, CA
• Providers in Merced, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.