Nelson M Fuentebella, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21977 Issued in CA

Practice address

9033 Wilshire Blvd
401
Beverly Hills, CA 90211-1837

Phone

(310) 247-0466

NPI assigned

Feb 21, 2013

Sex

Male

Sole proprietor

Yes

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spanish Hills Interventional Pain Specialists Inc a Medical CorpGroup PAC ID 9830345651, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Johns Regional Medical Center Hospital, Oxnard, CA, CCN 050082

Merit-based Incentive Payment System (MIPS)

Final score

90.95 of 100Reported as group

Quality

100

Improvement activities

40

Cost

48.44

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Spanish Hills Interventional Pain Specialists Inc a Medical Corp

  • Interventional Pain Medicine Physician
  • Camarillo, CA
  • NPI 1205195732
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • General Acute Care Hospital
  • Oxnard, CA
  • NPI 1073665360
  Care Compare affiliation

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1295075760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6635 ETIWANDA AVENUE",
            "address_2": "7",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9033 WILSHIRE BLVD",
            "address_2": "401",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111837",
            "telephone_number": "310-247-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTEBELLA",
        "first_name": "NELSON",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Mark Frisch, M.D., F.A.C.C.
• Deborah J Frutkin, CRNA
• Alon Frydman, DDS
• Albert Carol Fuchs, M.D.
• Anna Margaret Fuchs, MD
• Lucian Fulger
• Nicholas S Fuller, MD
• Functional Restoration Medical Center, Inc,
• Functional Restoration Medical Center, Inc,
• Fundaminsky Oral Facial DDS Inc

• Physician Assistant in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.