Active NPI
Marie Antonette Badua
- Family Nurse Practitioner
- Pomona, CA
National Provider Identifier
1457825754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95010352
- Practice address
- 1880 N Orange Grove Ave
Pomona, CA 91767-3006 - Phone
- (909) 620-7200
- Fax
- (909) 620-5800
- NPI assigned
- Jan 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95010352 | CA | Primary |
Addresses
Primary practice location
1880 N Orange Grove Ave
Pomona, CA 91767-3006
Mailing address
840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550
Other practice location 1
12990 Homestead Pl
Chino, CA 91710-3390
Phone (909) 438-0392
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1880 N Orange Grove Ave
Pomona, CA 91767-3006
Phone (909) 630-7158
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hospitalist Physician
- Pomona, CA
- NPI 1124317615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653004800000",
"number": "1457825754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 TOWNE CENTER DR",
"city": "POMONA",
"state": "CA",
"postal_code": "917675900",
"telephone_number": "909-398-1550",
"fax_number": "909-398-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1880 N ORANGE GROVE AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917673006",
"telephone_number": "909-620-7200",
"fax_number": "909-620-5800"
}
],
"practiceLocations": [
{
"address_1": "12990 Homestead Pl",
"address_purpose": "LOCATION",
"city": "Chino",
"state": "CA",
"postal_code": "917103390",
"country_code": "US",
"telephone_number": "909-438-0392",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BADUA",
"first_name": "MARIE ANTONETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-20",
"last_updated": "2022-05-20",
"certification_date": "2022-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95010352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.