Individual provider Active NPI

January Tiu, FNP-C

  • Family Nurse Practitioner
  • Lancaster, CA
National Provider Identifier
1427483452
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22995 Issued in CA
Practice address
43322 Gingham Ave
Suite 104
Lancaster, CA 93535-4576
Phone
(661) 874-4050
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22995 CA Primary

Addresses

Primary practice location

43322 Gingham Ave
Suite 104
Lancaster, CA 93535-4576

Mailing address

43322 Gingham Ave
Suite 104
Lancaster, CA 93535-4576
Phone (661) 874-4050

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20140626001011 CA Practitioner - Nurse Practitioner 7517182090 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1000 Franklin Pkwy
San Mateo, CA 94403-1922
Phone (650) 358-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22995CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bartz-Altadonna Community Health Center CurrentSince Dec 1, 2014 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Jul 24, 2023 Accepting new patients
Bartz-Altadonna Community Health Center CurrentSince Dec 1, 2014 Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Sep 20, 2013 Accepting new patients
Permanente Medical Group Inc CurrentSince Jul 24, 2023 Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

987 E Hillsdale Blvd
Foster City, CA 94404
Phone (650) 570-4631

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

43322 Gingham Ave
Ste 104
Lancaster, CA 93535
Phone (661) 874-4051

43322 Gingham Ave
Ste 105
Lancaster, CA 93535
Phone (661) 874-4029

43322 Gingham Ave
Lancaster, CA 93535
Phone (661) 579-9317

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

1000 Franklin Pkwy
San Mateo, CA 94403
Phone (650) 358-7000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

2791 Agoura Rd
Westlake Village, CA 91361
Phone 8054954938 ext. 8221

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1427483452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43322 GINGHAM AVE",
            "address_2": "SUITE 104",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354576",
            "telephone_number": "661-874-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43322 GINGHAM AVE",
            "address_2": "SUITE 104",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354576",
            "telephone_number": "661-874-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIU",
        "first_name": "JANUARY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.