Active NPI
Romeo Reyes Ladero Jr., NURSE PRACTITIONER
- Gerontology Nurse Practitioner
- Murrieta, CA
National Provider Identifier
1356869846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 95008999
- Practice address
- 38340 Innovation CT # D-404
Murrieta, CA 92563-2621 - Phone
- (951) 721-2768
- NPI assigned
- Sep 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 95008999 | CA | Primary |
Addresses
Primary practice location
38340 Innovation CT # D-404
Murrieta, CA 92563-2621
Mailing address
38340 Innovation CT # D-404
Murrieta, CA 92563-2621
Phone (951) 721-2768
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356869846 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovamed Industries LLC | Current | Accepting new patients | |
| Precisioncare Solutions LLC | Gerontology | Current | Accepting new patients |
| H Squared Health | Current | Accepting new patients | |
| Alliance Care Medical Equipment LLC | Current | Accepting new patients |
Locations
38340 Innovation Ct
#D404
Murrieta, CA 92563
Phone (951) 721-2768
Organizations & group practices 4
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.
-
- Oxygen Equipment & Supplies (DME)
- Murrieta, CA
- NPI 1851118046
-
- Durable Medical Equipment & Medical Supplies
- Murrieta, CA
- NPI 1619828902
-
- Gerontology Nurse Practitioner
- Murrieta, CA
- NPI 1700627379
-
- Internal Medicine Physician
- La Mesa, CA
- NPI 1982210183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1356869846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38340 INNOVATION CT # D-404",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925632621",
"telephone_number": "951-721-2768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38340 INNOVATION CT # D-404",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925632621",
"telephone_number": "951-721-2768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LADERO",
"first_name": "ROMEO",
"middle_name": "REYES",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-05",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "95008999",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1356869846",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Murrieta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.