Jose Manuel Celedon, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

59029 Issued in ID

Practice address

508 E Florida Ave
Nampa, ID 83686-5823

Phone

(208) 463-0118

NPI assigned

Aug 31, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medical Directors of Idaho PLLC

  • Internal Medicine Physician
  • Nampa, ID
  • NPI 1710392410
  Medicare reassignment NPD
• Vibra Physicians LLC

  • Hospitalist Physician
  • Johnstown, CO
  • NPI 1659705424

  ID

  Medicare reassignment NPD
• Port of Hope Centers, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Nampa, ID
  • NPI 1356773618
  NPD (past)

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1326520719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 E SHADY GLADE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428245",
            "telephone_number": "208-989-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E FLORIDA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865823",
            "telephone_number": "208-463-0118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Fort St",
            "address_2": "# 111",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "83702",
            "country_code": "US",
            "telephone_number": "208-422-1000",
            "fax_number": "208-422-1319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CELEDON",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-31",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ID",
            "license": "59029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Francis Castellano, PA-C
• Angelica Castillo, LCPC
• Erin Castioni, AU.D.
• Glen M Castor, LD
• Grace Cazier, LMSW
• Centerpointe, Inc.
• Centerpointe, Inc.
• Centerpointe, Inc.
• Centerpointe, Inc.
• Centerpointe, Inc.

• Gerontology Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Gerontology Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.