Active NPI
Anthony Lucero
- Psychiatric/Mental Health Nurse Practitioner
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95022856
- Practice address
- 11262 Campus St
Loma Linda, CA 92350-1727 - Phone
- (909) 558-1000
- NPI assigned
- Jan 25, 2021
- Last updated
- Feb 16, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95022856 | CA | Primary |
Addresses
Primary practice location
11262 Campus St
Loma Linda, CA 92350-1727
Mailing address
11262 Campus St
Loma Linda, CA 92350-1727
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.87 of 100
- Quality
- 72.13
- Promoting interoperability
- 80
- Improvement activities
- 40
- Cost
- 77.36
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95022856 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Southern California TMS Center Inc | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients |
Locations
2045 Compton Ave
Ste 205
Corona, CA 92881
940 S Coast Dr
Ste 215
Costa Mesa, CA 92626
16055 Ventura Blvd
Ste 717
Encino, CA 91436
Phone (818) 215-0367
700 N Brand Blvd
Ste 460
Glendale, CA 91203
Phone (310) 488-0329
23832 Rockfield Blvd
Ste 130
Lake Forest, CA 92630
Phone (949) 297-6680
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
3711 Long Beach Blvd
Ste 910
Long Beach, CA 90807
2100 Sawtelle Blvd
Ste 206
Los Angeles, CA 90025
Phone (310) 467-5071
4221 Wilshire Blvd
Ste 455
Los Angeles, CA 90010
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
180 S Lake Ave
Ste 615
Pasadena, CA 91101
Phone (626) 683-9158
711 W Kimberly Ave
Ste 100
Placentia, CA 92870
10630 Town Center Dr
Ste 129
Rancho Cucamonga, CA 91730
1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200
299 W Hillcrest Dr
Ste 113
Thousand Oaks, CA 91360
3655 Torrance Blvd
Ste 240
Torrance, CA 90503
Interoperability endpoints
- alucero78976@direct.llu.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Family Medicine Physician
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- NPI 1558788331
-
- Body Imaging Physician
- Rialto, CA
- NPI 1700495363
-
- Adult Mental Health Clinic/Center
- Pasadena, CA
- NPI 1275822751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676505600000",
"number": "1356931182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11262 CAMPUS ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11262 CAMPUS ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501727",
"telephone_number": "909-558-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-25",
"last_updated": "2023-02-16",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95022856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.