Individual provider Active NPI

Anna Ruth Tabo Escudero, FNP-C

  • Nurse Practitioner
  • Orange, CA
National Provider Identifier
1396261673
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95007148 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-7812
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95007148 CA Primary
Family Nurse Practitioner 363LF0000X 95007148 CA

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

333 City Blvd W Ste 1205
Orange, CA 92868-2957

Other practice location 1

385 S Manchester Ave Unit 2032
Orange, CA 92868-3246
Phone (714) 801-9771

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
I20171226001276 CA Practitioner - Nurse Practitioner 3274891171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgeons of Orange a Medical GroupGroup PAC ID 6901705227, 116 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 634-5549

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95007148CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care Connect Medical Group CurrentSince Oct 16, 2019 Accepting new patients
University Surgeons of Orange a Medical Group CurrentSince Oct 28, 2017 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

436 W Colorado St
Ste 210C
Glendale, CA 91204
Phone (866) 227-3310

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

101 The City Dr S
Bldg 25B
Orange, CA 92868

101 The City Dr S
#4B
Orange, CA 92868

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

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.

Hospital & facility affiliations 2

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": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1396261673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD W STE 1205",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-7812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "385 S Manchester Ave Unit 2032",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683246",
            "country_code": "US",
            "telephone_number": "714-801-9771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESCUDERO",
        "first_name": "ANNA RUTH",
        "middle_name": "TABO",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007148",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.