NPIMap

Individual provider Active NPI

Stefan J Ripich, CNP

  • Adult Health Nurse Practitioner
  • Middletown, CA
National Provider Identifier
1316968266
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5900 Issued in CA
Practice address
21337 Bush St
Middletown, CA 95461
Phone
(707) 987-3311
Fax
(707) 987-2455
NPI assigned
Jul 23, 2006
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5900 CA Primary

Addresses

Primary practice location

21337 Bush St
Middletown, CA 95461

Mailing address

21337 Bush Street
Middletown, CA 95461
Phone (707) 987-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150313002090 CA Practitioner - Nurse Practitioner 8325058860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15630 18TH Ave
Clearlake, CA 95422-9336
Phone (707) 994-6486

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5900CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Clearlake Hospital Inc. CurrentSince Jun 1, 2023 Accepting new patients
Truecare LLC CurrentSince Jan 1, 2016 Accepting new patients
Santa Fe Medical Group, LLC Past Accepting new patients
Adventist Health Clearlake Hospital, Inc Past Accepting new patients
Adventist Health Clearlake Hospital Inc. Past Accepting new patients

Locations

15322 Lakeshore Dr
Ste 102
Clearlake, CA 95422
Phone (707) 994-2030

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

3600 Rodeo Ln
Ste A2
Santa Fe, NM 87507
Phone (505) 629-4400

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1316968266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21337 BUSH STREET",
            "city": "MIDDLETOWN",
            "state": "CA",
            "postal_code": "95461",
            "telephone_number": "707-987-3311",
            "fax_number": "707-987-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21337 BUSH ST",
            "city": "MIDDLETOWN",
            "state": "CA",
            "postal_code": "95461",
            "telephone_number": "707-987-3311",
            "fax_number": "707-987-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIPICH",
        "first_name": "STEFAN",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "5900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CA

Sources for this page

Verify at the official NPI Registry.