Individual provider Active NPI

Nicole Marie Musabelliu, NP-C

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1457772311
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000191 Issued in CA
Practice address
9110 Judicial Dr
8317
San Diego, CA 92122-6711
Phone
(858) 414-8724
NPI assigned
Dec 19, 2013
Last updated
Mar 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP5332 AZ
Family Nurse Practitioner 363LF0000X 95000191 CA Primary

Addresses

Primary practice location

9110 Judicial Dr
8317
San Diego, CA 92122-6711

Mailing address

9110 Judicial Dr
8317
San Diego, CA 92122-6711
Phone (858) 414-8724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20191025001818 AZ Practitioner - Nurse Practitioner 8628297900 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Siren Medical PCGroup PAC ID 6608298419, 19 clinicians

Practice addresses (Care Compare)

14631 N Cave Creed Rd
Suite 104
Phoenix, AZ 85022-4100
Phone (602) 715-2568

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.24 of 100Reported as group
Quality
66.21
Improvement activities
40
Cost
66.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP5332AZMDFamily Nurse Practitioner
95000191CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ternion Physician Group, PLLC CurrentSince Sep 17, 2019 Accepting new patients
J M Geiss DO Apc CurrentSince Dec 16, 2024 Accepting new patients
Siren Medical PC CurrentSince Dec 2, 2024 Accepting new patients
Senior Doc Arizona PC CurrentSince Dec 16, 2024 Accepting new patients
Senior Doc Az Medical PC CurrentSince Dec 16, 2024 Accepting new patients

Locations

4704 W Diana Ave
Glendale, AZ 85302
Phone (623) 247-3949

7201 W Camino San Xavier
Glendale, AZ 85308
Phone (623) 271-8704

14631 N Cave Creek Rd
Ste 103
Phoenix, AZ 85022

14631 N Cave Creek Rd
Ste 104
Phoenix, AZ 85022
Phone (602) 715-2568

2999 N 44th St
Ste 220
Phoenix, AZ 85018
Phone (602) 288-4059

42104 N Venture Dr
Ste D118
Phoenix, AZ 85086
Phone (623) 505-4479

2592 N Santiago Blvd
Orange, CA 92867
Phone (714) 577-2271

Interoperability endpoints

  • Direct secure messaging: nicole.musabelliu@57560418353156.direct.elationemr.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1457772311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9110 JUDICIAL DR",
            "address_2": "8317",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921226711",
            "telephone_number": "858-414-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 JUDICIAL DR",
            "address_2": "8317",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921226711",
            "telephone_number": "858-414-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSABELLIU",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5332",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.