Individual provider Active NPI

Abe Ruben Bernardo Baquir, FNP

  • Family Nurse Practitioner
  • Redondo Beach, CA
National Provider Identifier
1467731042
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20844 Issued in CA
Practice address
2114 Artesia Blvd
Redondo Beach, CA 90278-3014
Phone
(310) 392-8636
Fax
(310) 943-3521
NPI assigned
Aug 12, 2011
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 20844 CA Primary

Addresses

Primary practice location

2114 Artesia Blvd
Redondo Beach, CA 90278-3014

Mailing address

2114 Artesia Blvd
Redondo Beach, CA 90278-3014
Phone (310) 392-8636

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abe.baquir.p1@direct.venicefamilyclinic.nextgenshare.com Health Information Exchange (HIE)

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
I20180425002528 CA Practitioner - Nurse Practitioner 5395044127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venice Family ClinicGroup PAC ID 2264339126, shared by 17 NPIs, 101 clinicians

Practice addresses (Care Compare)

604 Rose Ave
Venice, CA 90291-2767
Phone (310) 664-7901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20844CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 2, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 2, 2018 Accepting new patients
Angel Kidney Care of Inglewood Inc Past Accepting new patients
Zahra Tabassian MD Inc PastSince Jul 1, 2001 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: abaquir753217@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1467731042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783014",
            "telephone_number": "310-392-8636",
            "fax_number": "310-943-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783014",
            "telephone_number": "310-392-8636",
            "fax_number": "310-943-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAQUIR",
        "first_name": "ABE RUBEN",
        "middle_name": "BERNARDO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abe.baquir.p1@direct.venicefamilyclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2114 Artesia Blvd",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902783014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.