Drucilla Adeniran, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021366 Issued in CA

Practice address

644 W 12TH St
Tracy, CA 95376-3437

Phone

(209) 832-8984

NPI assigned

Jun 28, 2022

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Patel & Pulliam Apmc

  dba Tracy Occupational Medical Center

  • Family Medicine Physician
  • Tracy, CA
  • NPI 1568522878
  Medicare reassignment NPD
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1356073381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1562 EGRET DR",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953768317",
            "telephone_number": "209-814-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 W 12TH ST",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763437",
            "telephone_number": "209-832-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADENIRAN",
        "first_name": "DRUCILLA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina M Adair, M.D.
• Dunni Ayobami Adalumo, M.D.
• Grace J. Adamovics, PHARM.D
• Simone Adams-Young
• Ramana Adapa, MD
• Lexzandra Adorable
• Advanced Home Health Care, LLC
• Advanced Imaging of Tracy LLC
• Aegis Treatment Centers, LLC
• Aria Afshar

• Family Nurse Practitioner in Tracy, CA
• Providers in Tracy, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.