Ronald Mar Tenorio Atillo, AG-ACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95008863 Issued in CA

Practice address

200 W Arbor Dr
San Diego, CA 92103-9000

Phone

(800) 926-8273

NPI assigned

Apr 6, 2018

Last updated

May 31, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chest and Critical Care Consultants a Medical GroupGroup PAC ID 7911987961, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ahmc Anaheim Regional Medical Center Hospital, Anaheim, CA, CCN 050226

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ratillo182573@direct.llu.edu

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.

• Chest and Critical Care Consultants a Medical Group

  dba Family Health Center of La Palma

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1598852717

  Acute Care

  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Innovative Medical Group

  dba Innovative Medical Group Temecula

  • Internal Medicine Physician
  • Temecula, CA
  • NPI 1003407735
  Medicare reassignment NPD
• Regents of the University of California

  • Anesthesiology Physician
  • San Diego, CA
  • NPI 1356444897
  Medicare reassignment NPD
• Temecula Valley Emergency Medical Associates

  • Specialist
  • Murrieta, CA
  • NPI 1407845092
  Medicare reassignment NPD
• Chest and Critical Care Consultants

  dba Southern California Sleep Disorders Specialists

  • Sleep Disorder Diagnostic Clinic/Center
  • Tustin, CA
  • NPI 1659450054
  NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Ghods Inc

  dba Besht Wellness

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1790344869
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahmc Anaheim Regional Medical

  dba AHMC Anaheim Regional Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1891938122
  Care Compare affiliation

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1346747391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 PARADISE WAY",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919503060",
            "telephone_number": "747-257-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28062 Baxter Rd",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925631401",
            "country_code": "US",
            "telephone_number": "951-290-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATILLO",
        "first_name": "RONALD MAR",
        "middle_name": "TENORIO",
        "name_prefix": "Mr.",
        "credential": "AG-ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95008863",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95008863",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "95008863",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FURNISHING NUMBER",
            "identifier": "95008863",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ASSOCIATION OF CRITICAL CARE NURSES",
            "identifier": "2000070078",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "768953",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF NURSING",
            "identifier": "95008863",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rylee Athwani, AMFT
• Kathleen-Ann Laxamana Atienza, LMFT
• Princess Eliz Segala Atienza, IBCLC
• Sharon Atienza, NP
• Nisa S. Atigapramoj, M.D.
• Fadi Atiya
• Sawsan Ismail Atiya, PHARM-D
• Alexander Atkin
• Colin Atkins
• Gus G Atkins IV, M.D.

• Acute Care Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.