Individual provider Active NPI

Ramella E Barjesteh, NP

  • Acute Care Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1306116298
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP21399 Issued in CA
Practice address
1441 Florida Ave
Modesto, CA 95350-4404
Phone
(209) 576-3525
Fax
(209) 576-3544
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP21399 CA
Nurse Practitioner 363L00000X 0024169813 VA
Acute Care Nurse Practitioner 363LA2100X NP21399 CA Primary

Addresses

Primary practice location

1441 Florida Ave
Modesto, CA 95350-4404

Mailing address

PO Box 1430
Suisun City, CA 94585-4430
Phone (209) 579-5628

Other practice location 1

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097 ext. 5289

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
I20140416002506 CA Practitioner - Nurse Practitioner 2163654500 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21399CAMDChiropractor
NP21399CAMDNurse Practitioner
0024169813VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalists of Modesto Medical Group Inc CurrentSince May 11, 2015 Accepting new patients

Locations

1700 McHenry Ave
Ste 65B
Modesto, CA 95350
Phone (209) 581-7063

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Organizations & group practices 1

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": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1306116298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945854430",
            "telephone_number": "209-579-5628",
            "fax_number": "209-579-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-576-3525",
            "fax_number": "209-576-3544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Coffee Rd",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953554201",
            "country_code": "US",
            "telephone_number": "209-521-6097 x5289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARJESTEH",
        "first_name": "RAMELLA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP21399",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024169813",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP21399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.