Charlotte Capulong, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP23824 Issued in CA

Practice address

130 West Route 66
Ste 326
Glendora, CA 91740-6252

Phone

(626) 963-8588

Fax

(626) 963-8578

NPI assigned

Jan 31, 2014

Last updated

Jan 31, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Mayflower Medical Group IncGroup PAC ID 6901804350, 7 clinicians

Grandview Medical Group IncGroup PAC ID 1456742485, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Grandview Medical Group, Inc.

  • Interventional Cardiology Physician
  • Covina, CA
  • NPI 1356007819
  Medicare reassignment Care Compare group NPD
• Mayflower Medical Group, Inc.

  • Internal Medicine Physician
  • West Covina, CA
  • NPI 1003188160
  Medicare reassignment Care Compare group NPD
• Cardiology Medical Group of San Gabriel Valley Inc

  • Cardiovascular Disease Physician
  • Covina, CA
  • NPI 1902881121
  NPD (past)
• Dr Oliver M Solomon Inc

  • Internal Medicine Physician
  • Glendora, CA
  • NPI 1609240126
  NPD (past)

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

• Emanate Health Medical Center

  dba Citrus Valley Medical Center Queen Of the Valley Campus

  • General Acute Care Hospital
  • West Covina, CA
  • NPI 1063441293
  Care Compare affiliation
• Emanate Health Medical Center

  dba Emanate Health Inter-Community Hospital

  • Psychiatric Hospital Unit
  • Covina, CA
  • NPI 1215063151
  Care Compare affiliation
• Emanate Health Medical Center

  dba Citrus Valley Medical Center Inter-Community Campus

  • General Acute Care Hospital
  • Covina, CA
  • NPI 1982629440
  Care Compare affiliation

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1417370065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917730457",
            "telephone_number": "909-971-9334",
            "fax_number": "909-971-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WEST ROUTE 66",
            "address_2": "STE 326",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406252",
            "telephone_number": "626-963-8588",
            "fax_number": "626-963-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPULONG",
        "first_name": "CHARLOTTE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP23824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NP23824",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stavro Y Cantartzoglou Jr.
• Valerie Irene Cantu
• Capital Home Health Care
• Capital Hospice Services
• Florence Cappleman, MD
• Jessica D Cardenas, BA
• Care Circle, LLC
• Care First Hospice Services Inc
• Care Unlimited Health Services, Inc
• Care Unlimited Health Services,Inc.

• Nurse Practitioner in Glendora, CA
• Providers in Glendora, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.