Individual provider Active NPI

Sheila De Jesus-Maranan, FNP

  • Family Nurse Practitioner
  • West Covina, CA
National Provider Identifier
1336631407
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007951 Issued in CA
Practice address
1115 S Sunset Ave Ste 200
West Covina, CA 91790-3940
Phone
(626) 732-8390
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95007951 CA Primary
Nurse Practitioner 363L00000X 95007951 CA

Addresses

Primary practice location

1115 S Sunset Ave Ste 200
West Covina, CA 91790-3940

Mailing address

1117 S Lark Ellen Ave
West Covina, CA 91791-3530
Phone (626) 665-6125

Other practice location 1

1117 S Lark Ellen Ave
West Covina, CA 91791-3530
Phone (626) 665-6125

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20200221001558 CA Practitioner - Nurse Practitioner 4183051667 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011

1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526

2370 S Azusa Ave
West Covina, CA 91792-1511
Phone (877) 608-0055

Merit-based Incentive Payment System (MIPS)

Final score
84.36 of 100Reported as group
Quality
60.04
Promoting interoperability
87
Improvement activities
40
Cost
69.31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Care Foundation CurrentSince Jan 1, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 29, 2024 Accepting new patients
Citrus Valley Physician Partners CurrentSince Sep 1, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Emanate Health Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 29, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1336631407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 S LARK ELLEN AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917913530",
            "telephone_number": "626-665-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE STE 200",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-732-8390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1117 S Lark Ellen Ave",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917913530",
            "country_code": "US",
            "telephone_number": "626-665-6125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE JESUS-MARANAN",
        "first_name": "SHEILA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007951",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.