Kartika Budiman, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP950101068 Issued in CA

Practice address

1450 E Holt Ave
Pomona, CA 91767-5822

Phone

(909) 630-7927

NPI assigned

Oct 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Apple Urgent Care IncGroup PAC ID 9436192713, 8 clinicians

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kartika.budiman.p1@direct.pacificpulm.nextgenshare.com
• Direct secure messaging: kbudiman67565@direct.llu.edu

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.

• Apple Urgent Care, Inc

  • Urgent Care Clinic/Center
  • Hemet, CA
  • NPI 1316005572
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Dispatchhealth-Ca, PC

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1639752553
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Apple Urgent Care, Inc

  • Urgent Care Clinic/Center
  • Perris, CA
  • NPI 1396444261
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Surgery Physician
  • Riverside, CA
  • NPI 1013967405
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1043242563
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Pacific Professional Surgical Group Inc

  • Trauma Surgery Physician
  • Riverside, CA
  • NPI 1578341608
  NPD (past)
• Professional Portable Radiologic Services Inc.

  • Physiological Laboratory
  • Houston, TX
  • NPI 1457087991
  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1295200038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3119 PARK VISTA DR",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767100",
            "telephone_number": "909-498-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675822",
            "telephone_number": "909-630-7927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4234 Riverwalk Pkwy Ste 230",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925053312",
            "country_code": "US",
            "telephone_number": "951-781-3672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUDIMAN",
        "first_name": "KARTIKA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2024-05-08",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP950101068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Lynn Brubaker, NONE
• Bruce W Barker, MD, Faap, Inc.
• Bryan X Lee MD a Professional Medical Corporation
• Heather Bryant
• Hannah Bucklin
• Adriana Buenaventura
• Socorro Buenaventura, LMFT
• Susana Buenrostro
• Allen Hai Bui, DC
• Bryan Bui

• Family Nurse Practitioner in Pomona, CA
• Providers in Pomona, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.