Individual provider Active NPI

Eloisa Agatep, FNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Palm Springs, CA
National Provider Identifier
1467851147
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
95000982 Issued in CA
Practice address
1100 N Palm Canyon Dr Ste 212
Palm Springs, CA 92262-4426
Phone
(760) 327-7900
Fax
(760) 327-7905
NPI assigned
Aug 18, 2014
Last updated
Jul 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 95000982 CA Primary

Addresses

Primary practice location

1100 N Palm Canyon Dr Ste 212
Palm Springs, CA 92262-4426

Mailing address

35800 Bob Hope Dr Ste 220
Rancho Mirage, CA 92270-1739

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
I20250609003167 CA Order and Referring Only - Nurse Practitioner 2466756051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95000982CAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Women's Healthcare, a Medical Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eloisa.agatep.1@33563.direct.athenahealth.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, 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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1467851147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35800 BOB HOPE DR STE 220",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR STE 212",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624426",
            "telephone_number": "760-327-7900",
            "fax_number": "760-327-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGATEP",
        "first_name": "ELOISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "95000982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.