Individual provider Active NPI

Lorena Herminia Ruiz, AG-ACNP

  • Acute Care Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1306205208
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95003658 Issued in CA
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4135
Phone
(951) 788-3000
NPI assigned
Feb 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95003658 CA Primary

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4135

Mailing address

27525 Sunray CT
Murrieta, CA 92562-2816
Phone (951) 788-3180

Other names 1

  • Lorena Herminia Rivas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20230714003565 HI Practitioner - Nurse Practitioner 5496054835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

550 S Beretania St
Honolulu, HI 96813-2496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003658CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Jun 1, 2023 Accepting new patients

Locations

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

550 S Beretania St
Ste 510
Honolulu, HI 96813
Phone (808) 536-3773

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1306205208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27525 SUNRAY CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622816",
            "telephone_number": "951-788-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "LORENA",
        "middle_name": "HERMINIA",
        "credential": "AG-ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95003658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORENA",
            "last_name": "RIVAS",
            "middle_name": "HERMINIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.