Individual provider Active NPI

Zandri Terlep, PA-C

  • Physician Assistant
  • Chino, CA
National Provider Identifier
1306573480
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61293 Issued in CA
Practice address
13193 Central Ave Ste 220
Chino, CA 91710-4179
Phone
(909) 591-0843
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 61293 CA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 61293 CA Primary

Addresses

Primary practice location

13193 Central Ave Ste 220
Chino, CA 91710-4179

Mailing address

PO Box 1034
Pomona, CA 91769-1034

Other practice location 1

1900 Royalty Dr Ste 120
Pomona, CA 91767-3047
Phone (909) 527-8090

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
I20221101002742 CA Practitioner - Physician Assistant 7911374160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgent Head and Neck Surgeons IncGroup PAC ID 6103246434, 6 clinicians

Practice addresses (Care Compare)

6848 Magnolia Ave
Suite 220
Riverside, CA 92506-2858
Phone (951) 981-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61293CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Algos Inc., a Medical Corporation Multi-Specialty CurrentSince Aug 11, 2022 Accepting new patients
Algos Inc., a Medical Corporation CurrentSince Aug 11, 2022 Accepting new patients

Locations

13193 Central Ave
Ste 220
Chino, CA 91710
Phone (909) 591-0843

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

1900 Royalty Dr
Ste 120
Pomona, CA 91767
Phone (909) 450-0377

69780 Stellar Dr
#A
Rancho Mirage, CA 92270
Phone (760) 424-3380

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1306573480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1034",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917691034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE STE 220",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104179",
            "telephone_number": "909-591-0843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Royalty Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917673047",
            "country_code": "US",
            "telephone_number": "909-527-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERLEP",
        "first_name": "ZANDRI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "61293",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.