Individual provider Active NPI

Deborah K. Scheuerell, N.P.

  • Nurse Practitioner
  • Pomona, CA
National Provider Identifier
1417055807
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
301492 / 11530 Issued in CA
Practice address
887 E. Second Street
Pomona, CA 91766-2009
Phone
(909) 620-7769
Fax
(877) 778-6944
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 301492 / 11530 CA Primary

Addresses

Primary practice location

887 E. Second Street
Pomona, CA 91766-2009

Mailing address

625 Fair Oaks Ave Ste 270
South Pasadena, CA 91030-5801
Phone (636) 346-5245

Other practice location 1

1514 Valley Vista Dr
Diamond Bar, CA 91765-3929
Phone (909) 860-1144

Other identifiers 2

IdentifierTypeStateIssuer
RN301492MedicaidCA
P01272661OtherCARAILROAD MEDICARE-DU4032

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
I20060421000217 CA Practitioner - Nurse Practitioner 3274543186 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
301492 / 11530CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El Proyecto del Barrio, Inc. CurrentSince May 17, 2024 Accepting new patients
El Proyecto del Barrio, Inc. CurrentSince May 17, 2024 Accepting new patients
El Proyecto del Barrio, Inc. Current Accepting new patients
Joseph M Molina MD Professional Corporation-Southern California Past Accepting new patients

Locations

8902 Woodman Ave
Arleta, CA 91331
Phone (818) 830-7033

150 N Azusa Ave
Azusa, CA 91702
Phone (626) 969-7885

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1417055807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 FAIR OAKS AVE STE 270",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910305801",
            "telephone_number": "636-346-5245",
            "fax_number": "626-863-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 E. SECOND STREET",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662009",
            "telephone_number": "909-620-7769",
            "fax_number": "877-778-6944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Valley Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Diamond Bar",
            "state": "CA",
            "postal_code": "917653929",
            "country_code": "US",
            "telephone_number": "909-860-1144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHEUERELL",
        "first_name": "DEBORAH",
        "middle_name": "K.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "301492 / 11530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN301492",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-DU4032",
            "identifier": "P01272661",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.