Individual provider Active NPI

Zhike Pruett, N.P.

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1295086262
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22373 Issued in CA
Practice address
4060 Fourth Ave
Suite 220
San Diego, CA 92103-2116
Phone
(866) 284-2771
Fax
(619) 297-8379
NPI assigned
Sep 30, 2012
Last updated
Jul 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22373 CA Primary

Addresses

Primary practice location

4060 Fourth Ave
Suite 220
San Diego, CA 92103-2116

Mailing address

9610 Granite Ridge Dr
Suite B
San Diego, CA 92123-2684
Phone (866) 284-2771

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
I20170201002015 CA Practitioner - Nurse Practitioner 6406139229 Reassigns benefits to 5 organizations
Practice locations: Lemon Grove, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gandhi & Gandhi Medical Corporation CurrentSince Jun 1, 2020 Accepting new patients
Prema Sai Medical, P.C. CurrentSince Dec 23, 2017 Accepting new patients
Asim Guha Roy, M.D., Inc CurrentSince Jun 11, 2019 Accepting new patients
NR Medical Associates CurrentSince Dec 17, 2016 Accepting new patients
Elion Brace MD Inc CurrentSince Dec 21, 2017 Accepting new patients
Ali Alamar MD a Professional Corp CurrentSince Jul 9, 2017 Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

230 Prospect Pl
Ste 220
Coronado, CA 92118
Phone (559) 593-6450

2658 Del Mar Heights Rd
Del Mar, CA 92014
Phone (619) 402-4919

1940 El Cajon Blvd
San Diego, CA 92104
Phone (619) 543-4500

230 Prospect Pl
Ste 340D
San Diego, CA 92118
Phone (559) 593-6450

302 Washington St
San Diego, CA 92103
Phone (800) 790-0890

3520 4th Ave
San Diego, CA 92103
Phone (619) 291-5270

4075 54th St
San Diego, CA 92105
Phone (619) 582-5168

4540 Kearny Villa Rd
Ste 106
San Diego, CA 92123
Phone (858) 430-6656

555 Washington St
San Diego, CA 92103
Phone (619) 260-8300

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ability Home Health Services IncSan Diego, CA, CCN 559080 Home health agency 5% Or Greater Direct Ownership Interest (34%)
Corporate Officer (20%)
Corporate Director (50%)
Operational/Managerial Control (12.5%)
Mar 13, 2020
Mar 13, 2020
Mar 13, 2020
Mar 13, 2020
Blessed Hospice California, Inc.San Diego, CA, CCN B41582 Hospice 5% Or Greater Direct Ownership Interest (90%)
W-2 Managing Employee
May 22, 2023
Sep 4, 2020

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1295086262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9610 GRANITE RIDGE DR",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232684",
            "telephone_number": "866-284-2771",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE",
            "address_2": "SUITE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "866-284-2771",
            "fax_number": "619-297-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "ZHIKE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-30",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "22373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.