Individual provider Active NPI

Lisa J Nagle, FNP-BC

  • Family Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1336955053
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95031371 Issued in CA
Practice address
92 Ashdale
Irvine, CA 92620-7311
Phone
(909) 702-9392
NPI assigned
Dec 6, 2024
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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 95031371 CA Primary

Addresses

Primary practice location

92 Ashdale
Irvine, CA 92620-7311

Mailing address

3521 Morning Star LN
Norco, CA 92860-3736
Phone (909) 227-0587

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
I20250317001332 CA Practitioner - Nurse Practitioner 3678095999 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95031371CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Institute of Critical Care Medicine, Inc CurrentSince Mar 1, 2025 Accepting new patients
Western Comprehensive Care Clinic PC CurrentSince May 10, 2025 Accepting new patients

Locations

351 Corporate Terrace Cir
Corona, CA 92879
Phone (657) 234-7540

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1336955053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 MORNING STAR LN",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603736",
            "telephone_number": "909-227-0587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 ASHDALE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926207311",
            "telephone_number": "909-702-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLE",
        "first_name": "LISA",
        "middle_name": "J",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.