Haide Landeros, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21200 Issued in CA

Practice address

415 Old Newport Blvd Ste 200
Newport Beach, CA 92663-4252

Phone

(949) 548-9611

Fax

(949) 548-9958

NPI assigned

Nov 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

University of California, Geffen School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JMC Medical CorporationGroup PAC ID 7618364928, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BDEHCD
• Direct secure messaging: hlanderos41716@altamed.direct-ci.com

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.

• JMC Medical Corporation

  • Cardiovascular Disease Physician
  • Newport Beach, CA
  • NPI 1003562398
  Medicare reassignment Care Compare group NPD
• Good Samaritan Hospital, L.P.

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1376595777
  NPD (past)

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1447537451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR",
            "address_2": "STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "866-646-3553",
            "fax_number": "562-622-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 OLD NEWPORT BLVD STE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634252",
            "telephone_number": "949-548-9611",
            "fax_number": "949-548-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDEROS",
        "first_name": "HAIDE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-04",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21200",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quan Minh Lam, PA
• Kristy Lambaren, FNP
• Val Lambros II, M.D.
• Lance H. Betson, D.O. a Medical Corporation
• Michael Ross Land, D.O.
• Valerie Lang
• Erik Charles Langslet
• Brock Justin Lanier, MD
• Haley Kirsten Lantiegne, MA, ATC
• Salomone Lao

• Family Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.