Individual provider Active NPI

Alex Andria Judkins, FNP-BC

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1326748310
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025512 Issued in CA
Practice address
3111 Camino del Rio N Ste 625
San Diego, CA 92108-5718
Phone
(858) 433-5328
NPI assigned
Mar 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025512 CA Primary

Addresses

Primary practice location

3111 Camino del Rio N Ste 625
San Diego, CA 92108-5718

Mailing address

3111 Camino del Rio N Ste 625
San Diego, CA 92108-5718
Phone (858) 433-5328

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
I20230523003017 CA Practitioner - Nurse Practitioner 2466818083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pouya Afshar MD IncGroup PAC ID 1557656337, 19 clinicians

Practice addresses (Care Compare)

3111 Camino del Rio N
Suite 625
San Diego, CA 92108-5718
Phone (619) 738-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95025512CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pouya Afshar MD Inc CurrentSince Oct 3, 2023 Accepting new patients
Careconnectmd Ca PC Family Medicine CurrentSince Jun 16, 2023 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

3111 Camino del Rio N
Ste 625
San Diego, CA 92108
Phone (619) 738-5566

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

Organizations & group practices 2

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": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1326748310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 CAMINO DEL RIO N STE 625",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085718",
            "telephone_number": "858-433-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 CAMINO DEL RIO N STE 625",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085718",
            "telephone_number": "858-433-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDKINS",
        "first_name": "ALEX",
        "middle_name": "ANDRIA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.