Individual provider Active NPI

Laurel Amber Decou, NP

  • Family Nurse Practitioner
  • Hayward, CA
National Provider Identifier
1437885118
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021884 Issued in CA
Practice address
22331 Mission Blvd
Hayward, CA 94541-3911
Phone
(510) 471-5880
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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 95021884 CA Primary

Addresses

Primary practice location

22331 Mission Blvd
Hayward, CA 94541-3911

Mailing address

689 43Rd St
Oakland, CA 94609-1839
Phone (510) 912-6662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240216001902 OR Practitioner - Nurse Practitioner 6901274430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lane County OregonGroup PAC ID 7416853833, 31 clinicians

Practice addresses (Care Compare)

2073 Olympic St
Springfield, OR 97477-3413
Phone (541) 682-3550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95021884CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lane County Oregon CurrentSince Nov 30, 2023 Accepting new patients

Locations

1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-3551

2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530

Interoperability endpoints

  • Direct secure messaging: ldecou684172@direct.ochin.org
  • Direct secure messaging: laurel.decou.p1@direct.lanecounty.nextgenshare.com

Organizations & group practices 1

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": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1437885118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 43RD ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091839",
            "telephone_number": "510-912-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413911",
            "telephone_number": "510-471-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOU",
        "first_name": "LAUREL",
        "middle_name": "AMBER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.