Individual provider Active NPI

Julie A. Nelson, LCSW

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1366693376
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 18708 Issued in CA
Practice address
2080 South E St
Suite 100 Telecare
San Bernardino, CA 92408
Phone
(909) 388-9191
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 18708 CA Primary

Addresses

Primary practice location

2080 South E St
Suite 100 Telecare
San Bernardino, CA 92408

Mailing address

PO Box 7488
Moreno Valley, CA 92552-7488
Phone (951) 347-4030

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050518001185 CA Practitioner - Clinical Social Worker 5991746067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jun R. Chiong, MD, MPH, Inc.Group PAC ID 5597925974, 12 clinicians

Practice addresses (Care Compare)

1605 Valle del Sol
Redlands, CA 92373-7438

414 Tennessee St
Suite XX
Redlands, CA 92373-8163
Phone (909) 475-7371

Merit-based Incentive Payment System (MIPS)

Final score
68.08 of 100Reported as group
Quality
5.65
Promoting interoperability
92
Improvement activities
40
Cost
61.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 18708CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jun R. Chiong, MD, MPH, Inc. CurrentSince Aug 2, 2021 Accepting new patients
Medex Specialty Network, Inc. CurrentSince May 20, 2024 Accepting new patients

Locations

414 Tennessee St
Ste Xx
Redlands, CA 92373
Phone (909) 475-7371

461 Tennessee St
Ste C
Redlands, CA 92373
Phone (909) 475-7371

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3574/brand/1/csg/1/fhir/r4
  • Direct secure messaging: julie.ann.nelson.1@3574.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1366693376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7488",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925527488",
            "telephone_number": "951-347-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 SOUTH E ST",
            "address_2": "SUITE 100 TELECARE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-388-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JULIE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 18708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.