Individual provider Active NPI

Jose A Zepeda, FNP

  • Family Nurse Practitioner
  • El Centro, CA
National Provider Identifier
1407218936
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003783 Issued in CA
Practice address
1420 Ocotillo Dr Ste B
El Centro, CA 92243-4251
Phone
(619) 334-4869
Fax
(619) 334-4940
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 95003783 CA
Family Nurse Practitioner 363LF0000X 95003783 CA Primary

Addresses

Primary practice location

1420 Ocotillo Dr Ste B
El Centro, CA 92243-4251

Mailing address

1501 Ocotillo Dr Ste C
El Centro, CA 92243-4217
Phone (760) 353-6363

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
I20210426000771 CA Practitioner - Nurse Practitioner 5193083517 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003783CAMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Valley Family Care Medical Group Apc CurrentSince Mar 15, 2021 Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Mar 15, 2021 Accepting new patients
Cabrillo Center for Rheumatic Disease Apc Family CurrentSince May 1, 2024 Accepting new patients

Locations

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

1501 Ocotillo Dr
Ste C
El Centro, CA 92243
Phone (760) 353-6363

1420 Ocotillo Dr
Ste B
El Centro, CA 92243
Phone (760) 352-2551

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

5030 Camino de la Siesta
Ste 106
San Diego, CA 92108
Phone (619) 692-4401

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIABDD/Endpoint/FIABDD
  • FHIR API: https://api.platform.athenahealth.com/16606/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1407218936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 OCOTILLO DR STE C",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434217",
            "telephone_number": "760-353-6363",
            "fax_number": "760-353-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 OCOTILLO DR STE B",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434251",
            "telephone_number": "619-334-4869",
            "fax_number": "619-334-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEPEDA",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "95003783",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.