Individual provider Active NPI

Evelyn Chua Myrick, FNP-C

  • Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1386058006
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95000738 Issued in CA
Practice address
4501 X St FL 2
Sacramento, CA 95817-2229
Phone
(916) 734-5959
Fax
(916) 703-5265
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000738 CA
Nurse Practitioner 363L00000X 95000738 CA Primary

Addresses

Primary practice location

4501 X St FL 2
Sacramento, CA 95817-2229

Mailing address

4501 X St Ste 3016
Sacramento, CA 95817-2229
Phone (916) 734-3772

Other practice location 1

2081 Bronze Star Dr
Woodland, CA 95776-5423
Phone (530) 668-2600

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141014002250 CA Practitioner - Nurse Practitioner 6305067422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

4501 X St
Sacramento, CA 95817-2229
Phone (916) 734-5959

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Jul 1, 2020 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 1, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 26, 2021 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca CurrentSince Jul 26, 2021 Accepting new patients
Dignity Community Care Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

4501 X St
Fl 2
Sacramento, CA 95817
Phone (916) 734-5959

4501 X St
Ste 3016
Sacramento, CA 95817
Phone (916) 734-3771

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4501 X St
Sacramento, CA 95817
Phone (916) 734-5959

2279 45th St
Fl 2
Sacramento, CA 95817
Phone (916) 734-5958

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2425 Stockton Blvd
Sacramento, CA 95817
Phone (916) 453-2000

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1386058006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 X ST STE 3016",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172229",
            "telephone_number": "916-734-3772",
            "fax_number": "916-734-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 X ST FL 2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172229",
            "telephone_number": "916-734-5959",
            "fax_number": "916-703-5265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2081 Bronze Star Dr",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "CA",
            "postal_code": "957765423",
            "country_code": "US",
            "telephone_number": "530-668-2600",
            "fax_number": "530-661-1081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "EVELYN",
        "middle_name": "CHUA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000738",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95000738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.